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A POPULAR TREATISE 



DEAFNESS: 



ITS CAUSES AND PREVENTION. 



BY DRS. LIGHTHILL. 
ii 

EDITED BY 

E. BU^FORD LIGHTHILL, M.D. 



WITH ILLUSTRATIONS. 



' HE THAT HATH EARS TO HEAR, LET HIM HEAR." 



NEW YORK : 
ffiu'Letaiz, $pLLLLLs.kej L , J±i 3 J^j^aadiucuf, 

(Late Eudd & Caeleton.) 

M.DCCC.LXII. 




<6 \^ 



Entered, according to Act of Congress, in the year 1862, by 
E. BCJNFOKD LIGHTHILL, M. D., 

In the Clerk's Office of the District Court of the United States for the South- 
ern District of New York. 






ieilknti0«, 



J. M. CARNOCHAN, M.D., 

8TTRGEON-IN-CHIEF TO THE N. Y. STATE HOSPITAL AND PROFESSOR OF 
CLINICAL SURGERY TO THE N. Y. MEDICAL COLLEGE, 



IN ADMIRATION OF THE 

HIGH PROFESSIONAL ATTAINMENTS WHICH HATE PLACED HIM AMONG 

THE FIRST OF LIVING SURGEONS, AND IN 

GRATEFUL ACKNOWLEDGMENT OF PROFESSIONAL KINDNESS, 

THESE PAGES ARE 

RESPECTFULLY INSCRIBED. 



PEEFAOE, 



During an extensive and constant practice, de- 
voted to a considerable extent to the treatment of 
diseases of the Ear, the Authors have had abundant 
opportunities of observing the fact, that in a large 
number of cases the loss or impairment of hearing, 
originates from gross mismanagement of the Ear, 
evincing, on the part of the general public, a deplor- 
able degree of ignorance in regard to matters con- 
cerning this highly valuable organ. 

The present little volume owes its existence to 
these observations and to a sincere desire to preserve 
the sense of hearing as much as possible, by dissemi- 
nating a proper knowledge of the causes which pro- 
duce deafness, and the means best calculated for its 
prevention. 

The Authors have endeavored to treat the sub- 



6 PREFACE. 

ject as comprehensively as is practicable in a work of 
this character, by explaining the Anatomy and Phy- 
siology of the Ear, and describing those of the dis- 
eases of this organ, most destructive to hearing. 

They have abstained from giving directions for 
treatment, (except in a few cases,) as by furnishing 
receipts and formulas for treatment, in a popular trea- 
tise, persons are apt to be induced to constitute them- 
selves their own physicians, a practice always pro- 
ductive of more injury than benefit, especially when 
applied to an organ as complicated and delicate as the 
Ear, which requires a most thorough examination, 
before suitable treatment of any kind can be insti- 
tuted, even by competent medical men. 

Should the information contained in the following 
pages accomplish, in any degree, the object in view, 
the Authors would consider themselves abundantly 
repaid for their labor. 

34 St. Mark's Place, New York. ) 
8 Boylston Place, Boston. ) 

February, 1862. 



TABLE OF CONTENTS, 



PAGE 

The Value of Hearing, . . . * .11 

The great disadvantages of Deafness, . . 13 

The Ear, . . . . . . .17 

Anatomy of the Ear, . . . . 17 

The External Ear, . . . . .18 

The Drum-head, . . . . 18 

The Middle Ear, . . . . .21 

The Ossicles or Small Bones, . . . 21 

The Eustachian Tube, . . . .22 

The Inner Ear, . . . . . 23 

Acoustics, . . . . . . .27 

The Physiology of the Ear, .... 32 

The Causes of Deafness, . . . . .36 

Diseases of the Ear, . . . . . 36 

The inciting Causes of Diseases of the Ear, . . 37 

Cold, ...... 37 

Draughts of Air, . . . . .38 

Bathing, ..... 39 



8 CONTENTS. 






PAGE 


Violence to the Ears, 


. 39 


Loud Reports, .... 


39 


Throat-Affections, .... 


. 40 


Description of the Mucous Membrane, . 


43 


Scarlet-Fever, .... 


. 44 


Influenza, .... 


45 


Catarrh, ..... 


. 45 


Diptheria, .... 


46 


Diseases of the Skin, 


. 46 


Typhoid Fever, 


46 


Diseases of the Brain, 


■ .46 


Quinine, .... 


47 


Diseases of the External Ear, . 


. 48 


Inflammation of the Auricle, 


48 


Its Acute Form, 


. 49 


Its Chronic Form, 


49 


Inflammation of the Auditory Canal, 


. 50 


Its Acute Form, 


50 


Its Chronic Form, .... 


. 51 


Polypus, .... 


52 


Inflammation of the Ceruminous Glands, 


. 52 


Hardened Ear-wax, 


53 


Effects on Hearing, .... 


. 57 


Inflammation of the Membrana Tympani, 


57 


Its Acute Form, .... 


. 58 


Its Chronic Form, 


58 


Its effects on Hearing, 


. 58 


Diseases of the Middle Ear, . 


60 


Inflammation of the Eustachian Tube, . 


. 60 


Inflammation of the Tympanum, 


62 


Its Acute Form, .... 


62 


Its Chronic Form, . . 


65 


Its effects on Hearing, 


. 67 


Nervous Deafness, . 


68 


Otalgia, or Nervous Ear-ache, 


. 69 



CONTENTS. 



Otorrpkea; or, Discharge from the Ear, . . 70 

Its Causes, . . . . . .70 

Its Progress, . . . . . 71 

Its danger to the Ear, . . . . .72 

Its danger to Life, . . . . . 72 

Irrational Ideas concerning its Removal, . . 74 

The Refutation of these Popular Fallacies, . . 74 

The Necessity of a Systematic Treatment, . * . 75 

The Benefits resulting from its Removal, . . 76 

The Causes or the Frequency of Deafness, . . 78 

Procrastination, ..... 80 

Empirical Treatment, . . . . .81 

The Rational Treatment of Deafness, . . 86 

Remedial Agents, . . . . .87 

A New Method of Treatment, . . . 88 

The Curability of Deafness, . . . .91 

The Prevention of Deafness, .... 94 

Cleanliness, . . . , .94 

Protection against Cold, . . . . 95 

Precautions in Bathing, . . . . .96 

Warning against Ear-spoons, ... 96 

Punishment of Children, . . . .97 

Advice to Artillerists, . . . . 97 

Protection of the Feet, . . . . .99 

Rules for those predisposed to Colds, . . . 100 

Necessary Caution during Attacks of Influenza, . . 101 

Rules to be observed during Attacks of Scarlet Fever, 101 
Measles, ....... 102 

Scrofula, . . . . . . 102 

Foreign Bodies in the Ear, . . . .104 

Directions for their Removal, . . . 106 
Deafness in one Ear, ..... 107 



Symptoms of Diseases of the Ear, 

Method of detecting Incipient Deafness, 
1* 



109 
110 



10 CONTENTS. 

PAGE 

Ear-ache, . . . . . . 110 

Noises, . . . . . . .111 

Discharge from the Ear, . . . . Ill 

Warning against Procrastination, . . .112 

Caution against Empirical Treatment, . . 112 

Review of some of the Popular PiEmedies for Deafness, 114 

Sweet Oil, . . . . . .115 

The Syringe and Soap-suds, . . . .116 

Glycerine, . . . . . . 117 

Sulphuric Ether, . . . . .118 

Electricity, . . . . . . 118 

Artificial Drum -heads, . . . . .119 

Ear-Trumpets, . . . . .120 

Deaf-Mutism ; or, Dumbness in connection with Deafness, 122 



DEAFNESS: 

ITS CAUSES AND PREVENTION. 



THE VALUE OF HEAKING. 

Hearing is one of the most important of our 
senses. Considering it as a means of obtaining 
information, in infancy especially, it is more im- 
portant even than sight, for without it, speech, 
the peculiar attribute of man, cannot be devel- 
oped. Its importance for social intercourse, intel- 
lectual improvement, and for communication with 
the outer world, cannot be over-estimated. 

The pleasures which we derive from it are nu- 
merous, intense and varied, and contribute con- 
tinually to embellish life. Through no other sense 
can our soul receive such profound impressions as 



12 DEAFNESS .* ITS CAUSES 

through, that of hearing, a fact which is constantly 
demonstrated. The solemn notes of the organ ap- 
peal at once to the heart, and lift our thoughts in- 
voluntarily to the Throne of Grace. The exciting 
strains of martial music stimulate courage and 
bravery, and deeds of the greatest daring are per- 
formed under its soul-inspiring influence. The 
mournful strains of a funeral dirge move our 
heart to sadness, while the lively and pleasant 
music of a ball-room orchestra drives away care, 
cheers our spirit, and induces us to perform a 
series of movements, which, if done without 
its influence, would expose us to extreme ridi- 
cule. 

The chirping of insects, the songs of birds, the 
rustling of the leaves, the gurgling of the brook, 
the roar of the ocean, and the hum of the busy 
world around us, are sounds ever pleasant and 
contribute largely to our happiness. But far 
more soul-stirring and melodious than all those 
enumerated, is the human voice, which is ca- 
pable of giving utterance to sweeter sounds 
than any thing else in creation. To be in- 
capable of hearing that voice is an affliction 
great indeed. 

The Rev. Dr. Kitto, who became deaf at the 



AND PREVENTION. 13 

age of twelve years, in consequence of a fall from 
a housetop, says, in reference to his never having 
heard the voice of his children: "If there is 
one thing arising out of my condition, which 
more than another fills my heart with grief, 
it is this : to see their blessed lips in motion, 
and to hear them not, and to witness others 
moved to smiles by the sw T eet peculiarities of in- 
fantile speech, which are incomprehensible to me, 
and which pass by me like the idle wind." 



THE GEEAT DISADVANTAGES OF DEAFNESS. 

Good hearing is requisite in every department 
of life for the rapid interchange of our thoughts, 
ideas, and wants, and its loss or impairment a mis- 
fortune which makes itself felt at every step, and 
seriously interferes with our usefulness and suc- 
cess in all relations in life. It is a mildew to fond 
hopes and aspirations, and debars talent and ge- 
nius from reaping their legitimate reward. 

The inability of the fond mother to hear the 
anxiously expected cry, uttered by her new-born 
babe at its entrance into the world, or of the affec- 



14: DEAFNESS I ITS CAUSES 

tionate child to hear the dying request of a be- 
loved parent, mnst be a sad deprivation. 

Whether in Church or Theatre, Lecture-Room 
or Opera-House, in the Family Circle or sur- 
rounded by the pleasantest company, the deaf are 
constantly in a dreary and unbroken solitude. 

In this age of progress and improvement, it is 
necessary to have our senses perfect, even in the 
most ordinary business transactions, in order to 
keep pace with the times, — the necessity of ele- 
vating the voice, and of frequently repeating sen- 
tences while speaking to deaf persons, as well as 
the many mistakes arising from misapprehensions, 
are annoyances which we avoid as much as possi- 
ble by employing or transacting business with 
those, who hear readily. Besides detracting so 
much from the pleasures and advantages of life, 
deafness exercises a most baneful effect upon the 
temper and disposition, and presents in that re- 
spect the most striking contrast to the effect pro- 
duced by blindness. The blind are generally 
cheerful, frank, and sociable, but the deaf, on the 
contrary, are suspicious, morose, melancholic and 
unsociable to a degree, and constantly considering 
themselves the subject of remarks and ridicule, 
grow irritable and quarrelsome. 



AND PREVENTION". 15 

The lives of the poet Milton and the great 
musician Beethoven, illustrate most forcibly the 
comparative effects produced upon the temper by 
blindness and deafness. 

Milton, though lamenting in the most touch- 
ing strains his bitter calamity, still retained a 
cheerful and contented disposition, which he re- 
peatedly manifests in some passages of his " Para- 
dise Lost ; " while Beethoven, who became deaf 
in the prime of life, had all his latter years 
darkened by anguish, gloom and the deepest de- 
spair, and could scarcely find any alleviation of 
his misery from the enjoyment of the remaining 
senses. 

The sympathy which should be accorded to the 
deaf is usually withheld, as their infirmity is not 
so striking to the beholder as that of blindness. 
The mistakes arising from the latter condition 
move our hearts to pity, while laughter and mer- 
riment are often excited by the ludicrous mistakes 
of the deaf, from their misapprehensions of the 
language addressed to them. 

Even physically the effects of deafness are 
soon apparent. The countenance assumes an anx- 
ious, strained and nervous expression. The in- 
ability of many of the deaf to hear their 



16 DEAFNESS t ITS CAUSES 

own voice, prevents them from giving it the 
proper pitch, and they either talk in a loud and 
bellowing tone or in the merest whisper, while 
the voice itself loses its melodious quality, and 
assumes a peculiarly harsh and nasal character. 



AND PRETENTION. 17 



THE EAE. 

The Ear is the organ of hearing. Its diseased 
condition produces the misfortune which I have 
endeavored to portray in the preceding chapters. 
Before describing the diseases which may result 
in a partial or total loss of hearing, it is neces- 
sary to acquaint the reader with the anatomy of 
this organ, and the functions of its component 
parts. 



ANATOMY OF THE EAE. 

The Ear is divided into three parts : the Ex- 
ternal Ear, the Middle Ear or Tympanum, and 



18 DEAFNESS : ITS CAUSES 

the Inner Ear or Labyrinth, so called from its in- 
tricate construction. 



THE EXTERNAL EAR. 

The External Ear consists of the Auricle and 
the External Canal. The Auricle is a cartilagi- 
nous projection, with a great many depressions 
and elevations. Its size, shape and angle of at- 
tachment, varies in different races as well as in 
different individuals; from it the canal extends 
inward. 

The Canal is a tortuous irregularly curved 
tube of various calibre, and from an inch and a 
quarter to an inch and a half in length. 

In the integument which lines it are imbed- 
ded a number of glands, which secrete the ear-wax. 



THE DRUM-HEAD. 



Over the internal end of the Canal and her- 
metically closing it, is stretched the Membrana 
Tympanic or drum-head. In infancy it is of a 



AND PREVENTION. 



19 




ANATOMY OF THE EAE. 

A. Vestibule. 

B. Tympanum or Drum, at the bottom of which is the 

aperture of the Eustachian Tube. 

C. Cochlea. 

D. Membrana Tympani or Drum-head. 

1. Hammer. 

2. Anvil. 

3. Orbicular Bone. 

4. Stirrup. 

5. Muscle of the Stirrup. 

6. Fenestra Ovalis. 

7. Fenestra Rotundum. 



21 



pearly-grey color and semi-transparent ; in after- 
life however, it becomes nearly transparent and 
tlien it receives its color from the structure behind 
it. It is very delicate, being not thicker than very 
fine writing-paper, and is set in a bony ring sim- 
ilar to the manner in which a watch-crystal is set 
in its case. 



THE MIDDLE EAR. 

The Middle Ear, called the Tympanum* or 
Drum, is a small irregular cavity, from three- 
eighths to half an inch in its greatest diameter. 
It is bounded externally by the Drum-head and 
internally by the Labyrinth or Inner Ear. 



THE OSSICLES, OR SMALL BONES. 

A small chain of four extremely delicate bones, 
one end of which is firmly attached to the Mem- 

* The reader must bear in mind the difference between the 
Tympanum or Drum, and the Membrana Tynipani or Drum-head. 



22 DEAFNESS I ITS CAUSES 

brana Tympani, and the other to a membrane 
covering a cavity of the Inner Ear, stretches 
across the Drum. 

The first of these bones is called Malleus or 
Hammer, the second Incus or Anvil, the third Os 
Orbiculare or round bone, and the fourth Stapes 
or Stirrup. They are named so from their fancied 
resemblance to these several articles. The Ham- 
mer is attached to the Drum-head, and the Stirrup 
to the membrane of the Inner Ear. A small 
muscle is attached to the Hammer and another to 
the Stirrup. 



THE EUSTACHIAN TUBE. 

At the floor of the Drum is the aperture of a 
passage called the Eustachian Tube, which opens 
into the upper part of the throat behind the Pos- 
terior Xares, (or inner opening of the nostrils,) 
as the accompanying illustration will exemplify. 
The length of thi% tube is about an inch and a 
half ; the opening in the throat is the largest, 
being something like half an inch in diameter. 
As it approaches the ear it grows narrower but 
widens again at the entrance, so that the whole 



AND PRETENTION. 



23 




VERTICAL SECTION OF THE NASAL CAVITY, SHOWING THE MOUTH 
OF THE EUSTACHIAN TUBE. 

tube resembles a trumpet, with, its mouthpiece in 
the Drum. 

The mucous membrane of the throat is ex- 
tended through the Eustachian Tube to the Drum, 
lines that cavity and covers the small bones. 



THE INNER EAR. 

The Inner Ear or Labyrinth is wedged into the 
petrous portion of the temporal bone — the hard- 



24 DEAFNESS I ITS CAUSES 

est bone of the cranium. It is divided in the 
bony and membranaceous Labyrinth. The bony 
one is divided into three parts, the Vestibule, the 
Semi-circular Canals, and Cochlea. 

The Vestibule is a small irregular chamber 
about one-sixth of an inch in its longest diameter, 
having two small openings into the Drum, each 
covered by a delicate membrane ; these openings 
are called the Fenestra Ovalis and Fenestra Ro- 
tundum, or the oval and round windows ; to the 
membrane of the former the Stirrup is attached. 

The inner wall of the Vestibule consists of a 
sieve-like plate, through which pass the filaments 
of the Auditory Nerve together with some blood- 
vessels. 

The semi-circular canals are three small bony 
passages, two of which open into the Vestibule 
at both extremities, while the third opens into 
but one common passage, thus making five open- 
ings into the Vestibule. 

The Cochlea lies contiguous to the Vestibule, 
and rather in front of the Drum. In shape it re- 
sembles a snail-shell, hence its name. It is a 
conical canal about an inch and a half long, 
making two and a half turns around a central 
axis called the Modiolus. 



AND PREVENTION. 



25 



Around this axis a thin plate of bone winds 
like the thread of a screw ; the passage is di- 
vided into two Scala, one of which opens into the 
Vestibule and the other into the Drum by the 
Fenestra Rotundum. 

The whole of the bony Labyrinth is lined by 
a thin serous membrane which secretes a fluid 
called perilymph. 

The bony Labyrinth contains a membranaceous 
one, which consequently is its exact counterpart 
in form, but being smaller than that, the space 
intervening is filled with the perilymph before 




GENERAL DISTRIBUTION OF THE AUDITORY NERTE. 



alluded to. The Auditory nerve divides itself into 

two branches, one of which enters the Cochlea, the 
2 



26 DEAFNESS I IIS CAUSES 

other the Yestibule and semi-circular canals, and 
is distributed over the membranaceous labyrinth, 
terminating in very minute and highly delicate 
filaments. 



AND PREVENTION. 27 



ACOUSTICS. 

The vibrations of sonorous bodies give a trem- 
ulous or undulatoiy motion to the air by which 
they are surrounded, similar to the motion commu- 
nicated to smooth water when a stone is thrown 
into it. These undulations reaching the ear, pro- 
duce a sensation called sound. 

Sonorous bodies are those which produce 
clear, distinct, regular and durable sounds, such 
as a bell, a drum, musical strings or wind instru- 
ments. Although they owe their sonorous prop- 
erty to their elasticity, it is not to be inferred that 
all elastic bodies are sonorous. 

When the air surrounding a sonorous body is 
dense, sounds are loader than when it is in a 
rarefied state, and generally the intensity of sound 



28 DEAFNESS I ITS CAUSES 

increases with the density of the medium by which 
it is propagated. For this reason the sound of a 
bell is louder in cold, than in warm weather, and 
sound of any kind is transmitted to a greater dis- 
tance in cold clear weather than in a warm sultry 
day. On the top of high mountains, where the 
air is in a rarefied condition, the human voice can 
be heard only at the distance of a few rods, and 
the firing of a gun produces a sound scarcely 
louder than the cracking of a whip. 

When the air is humid it is a better conductor 
of sound than when it is dry. On this account 
a bell can be more distinctly heard just before 
rain, and sound is heard better in the night than 
in the day, because the air is generally clamper. 

A clear and frosty atmosphere is also favor- 
able to the transmission of sound, especially when 
the surface over which it passes is smooth and 
level. Conversation in the polar regions has been 
carried on between persons more than a mile 
apart. 

The vibrations of sonorous bodies can be com- 
municated to a distance not only through the 
air, but also through liquids and solid bodies. 
Through the latter medium it is communicated 
more rapidly and with greater power than through 



AND PREVENTION. 29 

the air or fluids. By water it is conducted about 
four times quicker than by air, and by solids about 
twice as rapidly as by water. 

If a person lay his head on a long piece of 
timber, he can hear the scratch of a pin at the 
other end, while it could not be heard through 
the air. If the Ear be placed against a long, dry 
brick wall, and a person strike it once with a 
hammer, the sound will be heard tivice, because 
the wall will convey it with greater rapidity than 
the air, though each will bring it to the ear. 

The earth is also a good conductor of sound ; 
hence we find the Indian, Arab, or other nomad, 
when they wish to ascertain the proximity of 
friend or foe, will lay their ear close to the ground, 
and by long practice can tell almost to a certainty, 
at what distance from them an object of friend- 
ship or suspicion may be. 

Sound passing through the air moves at the 
rate of 1120 feet in a second of time ; and this 
rule applies to all kinds of sound, whether loud or 
low. The softest whisper flies as fast as the loud- 
est thunder ; were it not for this uniform velocity, 
the music of a choir or of an orchestra at a short 
distance, would be but a strange confusion of dis- 
cordant sounds ; for the different instruments or 



30 DEAFNESS I ITS CAUSES 

voices, having different degrees of loudness, could 
not simultaneously reach the ear. 

Sounds may be conveyed to a much greater 
distance through continuous tubes than through 
the open air, as illustrated by the Acoustic Tubes 
used in public-houses, stores, counting-rooms, &c, 
to convey communications from one room to 
another. 

Sound as well as light is reflected, its reflec- 
tion being equal to its angle of incidence. After 
being reflected from several surfaces it may be 
collected into one point as a focus, where it will 
be more audible than in any other part. On this 
principle whispering-galleries may be constructed. 

The famous whispering-gallery in the dome of 
St. Paul's Church, in London, is constructed on 
this principle. Persons at very remote parts of 
the building can carry on a conversation in a soft 
whisper which will be distinctly audible to one 
another, while others in the building cannot hear 
it ; even the ticking of a watch may be heard 
from side to side. 

A church in Newburyport, Massachusetts, has 
the same property as a whispering-gallery, as 
was accidentally discovered. Persons in opposite 
corners of the building, by facing the wall, may 



AND PREVENTION. 31 

carry on a conversation in the softest whisper, 
unnoticed by others in any other part of the 
building. 

An echo is produced by the vibrations of the 
air meeting a hard and regular surface, such as a 
wall, a rock, a mountain, and being reflected back 
to the Ear, produces the same sound a second, 
and sometimes a third and fourth time. 

The quality of sound is affected by the furni- 
ture of a room, particularly the softer kinds, such 
as curtains, carpets, &c. ; because, having little 
elasticity, they present surfaces unfavorable to vi- 
brations. 

For this reason, music always sounds better in 
rooms with bare walls, without carpets and with- 
out curtains. For the same reason, a crowded 
audience increases the difficulty of speaking. 

As a general rule it may be stated, that plain 
and smooth surfaces reflect sound without dis- 
persing it ; convex surfaces disperse it, and con- 
cave surfaces collect it. 

The sound of the human voice is produced by 
the vibration of two delicate membranes, situ- 
ated at the top of the windpipe, between which 
the air from the lungs passes. 



32 DEAFNESS : ITS CAUSES 



THE PHYSIOLOGY OF THE EAR. 

The Auricle collects sound, an office which 
it is eminently fitted for on account of its 
size and elasticity, and from its being detached 
from the head and directed forward. The sound 
thus collected passes into the Auditory Canal, 
where it is not only intensified by the air exist- 
ing there, but also by being reflected from its 
walls, and is brought to a focus or concentrat- 
ing point upon the Membrana Tympani. There 
it produces the same phenomenon which the 
bow produces on the strings of a violin, i. e., 
vibration. The vibration thus produced, no 
matter how delicate it may be, is conveyed by 
the agency of the chain of small bones to the 
membrane of the Yestibule. As one end of this 



AXD PREVENTION. 33 

chain is attached to the Membrana Tympani, and 
the other end to the membrane of the vestibule, 
vibration of one membrane must produce a cor- 
responding effect on the other. 

Although one solid little bone would answer 
to convey vibrations from one membrane to the 
other, yet it is entirely owing to the mobility 
of this chain of bones, that we are enabled to hear 
the human voice in conversation, when the va- 
rious modulations produce so many different vi- 
brations in the most rapid succession. 

Through the Eustachian tube air is admitted 
to the Tympanum, so as to produce an equilibrium 
with the air in the External Canal, and permit 
the Drum-head to freely vibrate. "Without this 
presence of air in the drum, perfect vibration of 
its membrane would be impossible. The func- 
tions of the Eustachian tube may therefore be 
compared to those of the sidehole in an ordinary 
drum. 

The vibration of the Drum-head causes the air 
in the drum to vibrate also, and this in turn pro- 
duces a corresponding effect on the membrane of 
the Fenestra Rotunda, the opening of which com- 
municates with the Cochlea. The function per- 
formed by the chain of small bones in communi- 
2* 



34 DEAFNESS : ITS CAUSES 

eating vibrations of the Membrana Tympani to 
the membrane of the Fenestra Ovalis, is per- 
formed by the air, in communicating them to the 
membrane of the Fenestra Rotunda. 

The vibration of these two membranes pro- 
duces an agitation of the liquid called perilymph, 
which fills the intervening space between the 
membranaceous labyrinth and its bony case, and 
this agitation is felt or taken hold of, by the fila- 
ments of the Auditory Nerve, which are so deli- 
cately distributed over the membrane of the Laby- 
rinth, and therefore come in direct contact with 
this liquid. The impression thus received is 
conveyed by the Auditory Nerve to the brain, 
which conceives this impression as sound. 

The earwax secreted by the glands in the Ex- 
ternal Canal serves as a protection against cold, 
and the entrance of foreign bodies or insects. 
The two little muscles, one of which is attached 
to the Hammer and the other to the Stirrup, pro- 
tect the Auditory Nerve from being stunned by 
the too powerful and injurious impressions it 
would receive from very loud reports, as by their 
action the Membrana Tympani is put on a greater 
stretch. 

Acoustics teaches us that the more membranes 



AND PREVENTION. 35 

are stretched, the less are they able to vibrate, a 
fact easily demonstrated by a common drum. 
The office of the muscles is therefore to modify 
sound, and prevent as much as possible the sen- 
sation of stunning, an office somewhat analogous 
to that of the Iris z which contracts in strong light, 
and prevents the eye from being dazzled. 



36 DEAFNESS : ITS CAUSES 



THE CAUSES OF DEAFNESS. 

DISEASES OF THE EAR. 

The causes of deafness, physiologically con- 
sidered, may be enumerated under the following 
heads : 

1st. Closure, either partial or total, of the Ex- 
ternal Canal, so as to prevent the vibrations of the 
air from reaching the Heiribrana Tympani. 

2d. Impaired vibratility of that membrane, 

3d. Interrupted or imperfect communication 
of the vibrations to the inner ear. 

4th. Closure of the Eustachian tube, which 
prevents the air from reaching the Tympanum. 

5th. Inability of the branches of the Auditory 
nerve in the labyrinth to receive impressions, or 



AND PREVENTION. 37 

of the nerve itself to convey them to the brain; 
and 

6tli. Inability of the brain to conceive the im- 
pression, as sound. 

All tlie conditions above mentioned, with 
the exception of the last, (which depends on 
a diseased condition of the brain itself,) may be 
produced by diseases of the Ear, of the more 
important of which we shall give a brief de- 
scription. 



THE INCITING CAUSES OF DISEASES OF THE EAR. 

Cold. 

Cold stands preeminent as an agent productive 
of diseases of the Ear. Its action is very depress- 
ing ; under its influence sensibility is diminished, 
the secretions are checked, the circulation of the 
blood in trie capillaries is impaired, the tissues 
shrink, and the part affected becomes either pale 
from the want of blood, or purple from its stagna- 
tion. 

If the reaction consequent upon this depres- 
sion is carried to excess, there will be increased 



38 DEAFNESS : ITS CAUSES 

beat, accelerated circulation, redness, pain and 
swelling ; symptoms which constitute the morbid 
condition called inflammation. 

The more an organ is surrounded by cellular 
tissue and adipose matter, (or fat,) and the more 
plentiful is its supply of blood, the more it is able 
to resist the action of cold. The Ear is wholly de- 
prived of these natural protections. Being sur- 
rounded by nothing but bone, its circulation is 
but feeble, its temperature easily lowered, and the 
reaction consequent upon depression is generally 
productive of inflammation. 

Draughts of Air 

increase very much the effect of cold, and are 
therefora highly injurious to the Ears. 

If the surrounding air is at rest, the body cools 
slowly, but when it is in motion a fresh portion 
of the atmosphere takes constantly the place, of 
that which has been warmed by the surface of the 
body, and thereby increases the rapidity with 
which its heat is extracted. 

Cold not only affects us through the atmos- 
phere, but also through the instrumentality of 
water. Therefore a considerable number of dis- 
eases of the Ear are produced by 



AND PREVENTION. 39 

Bathing, 

especially if the water is allowed to enter the 
Ears. The shower bath, cold ablutions of the 
head, or cold applications dropped into the Ears 
are apt to affect them unfavorably. 

Violence to the Ears, 

such as boxing or pulling them, the practice of 
digging into them with Earspoons, the sting of 
insects, or the introduction into it of acrid sub- 
stances, is frequently the cause of inflammation. 

Loud Reports, 

such as those emanating from the discharge of 
guns or the shrill whistle of the locomotive, are 
very injurious to the nervous apparatus of the 
Ear. Gunners and people engaged in machine 
shops or iron mills, where the ponderous steam- 
trip-hammers produce so great a concussion, are 
always affected with nervous deafness to a greater 
or less degree. Rupture of the drum-head was 
formerly considered the greatest and most fre- 
quent danger resulting from this cause, but this 
has been disproved by experience. Among those 
whose hearing becomes impaired from it, we find 



40 DEAFNESS I ITS CAUSES, ETC. 

probably one person with a ruptured drum-head, 
to fifty where it is in a perfectly normal condition. 
The powerful concussion of air produced by heavy 
reports causes a sudden and violent pressure on 
the Drum-head. This membrane owing to its 
elasticity yields, but drives the stirrup (the bone 
attached to the fenestra ovalis) too far into the 
Labyrinth, causing too great an agitation of its 
liquid, and thus unduly excites the Auditory 
nerve. Owing to this effect the diver, while 
working in his apparatus underwater, frequently 
experiences a feeling of pain in the Ears and dizzi- 
ness, because the compressed air in the apparatus 
being denser than the air in the Tympanum, rushes 
into the External Canal to restore the equilibrium, 
and produces the phenomenon just described. 

Throat- Affections. 

Throat-Affections are the most fruitful sources 
of diseases of the Ear. They propagate themselves 
through the Eustachian tube by reason of the con- 
tinuity of the mucous membrane of the throat 
with that of the Middle Ear. As this membrane 
becomes frequently diseased and plays quite an 
important part in affections of the Ear, a short 
description of it will be found useful. 



4:2 DEAFNESS I ITS CAUSES 




SECTIONAL VIEW OF " THE NOSE, MOUTH, PHARYNX, ETC. 



AXD PREVENTION. 43 

Description of the Mucous Membrane. 

The gastro-pulmonary-mucous membrane lines 
the whole interior of the body, just as the skin 
covers the exterior. It commences at the edges 
of the lips and nostrils, proceeds through the nose 
and mouth to the throat, from whence it extends 
upward to line the Eustachian Tube and Middle 
Ear, (as already explained in the anatomy of the 
ear,) and proceeds downward to line the windpipe 
and its various divisions, as far as the air cells of 
the lungs. It is continued throughout the whole 
length of the Alimentary Canal and the Urinary 
apparatus to their several terminations. From 
the nose the membrane extends through the tear- 
passage until, under the name of Conjunctiva, it 
spreads over the eye-lids and fore part of the eye- 
balls. Other offsets line the frontal, maxillary, 
ethmoidal, and sphenoidal sinuses, (small cavities 
situated in the bones bearing the same names.) 

The mucous membrane is of a pinkish hue, 
plentifully supplied with bloodvessels, nerves and 
lymphatics, and in its healthy state is kept con- 
tinually moist by a peculiarly tough, whitish, and 
semi-transparent secretion called mucous. 

Inflammation produces a thickening of this 



44 DEAFNESS I ITS CAUSES 

membrane, of which we become easily aware by 
the difficulty experienced in breathing during 
an attack of cold, this difficulty being pro- 
duced by the thickened state of the mucous 
membrane of the nose. In the first stages of in- 
flammation the secretion of mucus is suspended 
and a peculiar dryness and irritation is the result, 
but soon the inflamed membrane begins to pour 
out a fluid, viscid, opaque, and resembling the 
white of an egg^ thus vastly differing from its 
usual secretion. 

Taking into consideration the continuity of 
the mucous membrane, it will be readily compre- 
hended how a disease of one part can be communi- 
cated to another and even distant part, and this is 
the reason why affections of the throat so easily 
produce similar affections in the Ear. 



Scarlet Fev 



er. 



Throat-Affections, of whatever character, may 
easily extend themselves to the Ear, but the 
inflammation of the throat occurring during an 
attack of Scarlet fever, is the most destruc- 
tive to that organ, and is the cause of at least 
one-third of the cases of deafness. 



AND PREVENTION. 45 

Influenza^ 

or the inflammation of the mucous membrane of 
the throat produced by cold, is fully as apt as 
Scarlet fever to excite diseases of the Ear, only in 
a less violent degree. Most every one has expe- 
rienced a little dulness of hearing during a heavy 
cold, this being caused either by the tumefaction 
of the membrane round the mouth of the Eusta- 
chian tube, or by the accumulation of hardened 
muco-purulent matter in the fauces. If resulting 
from the latter cause, the dulness of hearing is only 
temporary and will disappear when the cold passes 
off. Should the inflammation attack the Eusta- 
chian tubes, and extend itself to the Middle Ear, 
permanent deafness may be the result. 

Catarrh. 

Catarrh is a chronic inflammation of the mu- 
cous membrane of the nose, attended by a pro- 
fuse fetid discharge, which is thrown off through 
the nose or dropped into the throat and then 
hawked up. It impairs hearing in the same 
manner as diseases of the throat impair it, i. e., 
by extending itself through the Eustachian tube 
to the Middle Ear. This disease prevails quite 



46 DEAFNESS I ITS CAUSES 

extensively, and is frequently productive of deaf- 
ness. 

Diptheria. 

Diptheria is a certain form of malignant sore 
throat, which, has made its appearance in this 
country within the past three years to a consid- 
erable extent, and proves very fatal to hearing. 

Diseases of the Shin. 

The skin is extended into, and lines the Audi- 
tory Canal, and by this channel its various dis- 
eases are apt to be communicated to the ear. 
Measles, Small-pox, Erysipelas, &c, inflame fre- 
quently the External Canal and Drum-head. 

Typhoid Fever. 

Typhoid Fever is very apt to affect the Ear, 
and produces in some instances total deafness ; 
Mumps and Whooping-cough have also at times 
a very unfavorable effect on the Ear. 

Diseases of the Brain. 

The Ear being intimately connected with the 
brain by its nervous apparatus, very often suffers 
from the effects of diseases of that organ. Con- 



AND PREVENTION. 47 

cussion of the brain, produced by falls, or blows 
upon the head, brain fever, congestion of the 
brain or softening of it, frequently produce deaf- 
ness. 

Quinine, 

when taken for a lengthy period, may prove in- 
jurious to the Ears, and produce deafness in some 
constitutions. In warm and tropical climates, 
where this drug is extensively used as a remedy 
against the prevailing fevers, a great many per- 
sons may be found, whose hearing has become im- 
paired through its use. 



48 DEAFNESS : ITS CAUSES 



DISEASES OF THE EXTERNAL EAR. 

INFLAMMATION OF THE AURICLE. 

Inflammation of this part of the Ear is gener- 
ally attended to with more promptitude than that 
of any other part, not only because the pain 
attracts the patient's attention, but also because 
the change produced by the inflammation is easily 
recognized, and likely to be perceived at a glance, 
by any casual observer. 

If the disease is confined to the Auricle, it 
does not produce deafness, but as it can readily 
be communicated to the Auditory Canal and from 
thence to the more important parts of the Ear, 
the subject deserves consideration. 



AJUTD PREVENTION. 49 

Its Acute Form 

is generally ushered in with headache, loss of ap- 
petite, and more or less fever. The Ear looks red, 
and is swollen sometimes to such an extent as to 
obliterate its depressions and elevations entirely ; 
it feels hot, painful, itches, and is very sore to the 
touch or upon the slightest pressure. After a day 
or two, little vesicles or blisters appear on the sur- 
face, which burst and discharge a yellow matter 
or clear liquid ; after which scabs are formed, the 
Ear begins to feel easier, and is disposed to heal. 

Its Chronic Form 

is attended with the same symptoms as the acute, 
(of which it is often the sequel,) only they appear 
in a much milder degree. The pain is very mod- 
erate, sometimes entirely absent ; but the itching 
is usually very distressing. The Ear looks red, 
a little swollen, and is in some cases covered with 
scabs and little blisters which discharge a little 
matter, or may be affected with fissures or cracks 
which are very painful, itching, burning, and easily 
disposed to bleed. 

Causes. — Exposure to cold, the direct action 



50 DEAFNESS I ITS CAUSES 

of the sun's rays during hot weather, violent 
blows on the Ear, diseases of the skin, the sting 
of insects, and at times, the semi-barbarous prac- 
tice of piercing the lobes. 



INFLAMMATION OF THE AUDITORY 
CANAL. 

Inflammation of the External Canal is a fre- 
quent disease. Its lining is very delicate and 
plentifully supplied with nerves and blood-ves- 
sels, and coming in direct contact with the at- 
mosphere is subject to the adverse influences of 
its different changes and impurities. 

Its Acute Form 

commences, like all acute cases of inflammation, 
with feverishness, headache, &c. ; the hearing is 
dull, a feeling of heaviness, tension, or pain in the 
Ear is experienced, the pain being usually aggra- 
vated toward night, sometimes to an intolerable 
degree ; the secretion of wax is suspended, the 
lining membrane looks reel, and is swollen occa- 



AND PREVENTION, 51 

sionally to such, an extent that not even a probe, 
larger than a common pin, can be introduced. 
Moving the jaws or pressure in front of the Ears 
is very painful, a great deal of itching is expe- 
rienced, and a rumbling noise in the Ears annoys 
the patient. Soon a discharge of pus streaked 
with blood makes its appearance, the swelling and 
redness diminish, and the pain abates in violence. 

Its Chronic Form. 

In its Chronic form the symptoms are the 
same as in the acute, but in a less violent degree. 
In some cases the symptoms are so mild that no 
disease is suspected until a slight discharge is 
noticed ; most generally, however, there is a little 
pain and considerable itching. The lining looks 
red and is slightly swollen, and a discharge will 
sooner or later appear. 

Causes. — Besides the general causes mentioned 
under the proper head, — Cold, the entrance of 
water while bathing, cold or irritating applica- 
tions, the entrance of insects, or the use of Ear- 
spoons. 

Effects. — If inflamed for some time, the lining 
membrane loses its delicacy, becomes thickened 



52 DEAFNESS I ITS CAUSES 

and granulated, the granulations becoming so 
large in some cases as to completely block up 
the Canal. The inflammation gives also rise 
occasionally to the growth of 

Polypus, 

or little tumors of a soft, spongy structure, at- 
tached to the lining by a stem, bleeding easily 
and freely, and frequently growing so large as 
to completely obstruct the Auditory Canal and 
even to protrude into the Auricle, when they 
can be seen in the shape of a little bag ; gener- 
ally however they extend inward, and by press- 
ing on the Drum-head produce disagreeable 
noises. They irritate the lining of the Canal, 
increase the inflammation and discharge, and 
are a perpetual source of danger and annoy- 
ance. 



INFLAMMATION OF THE CERUMINOUS GLANDS. 



The glandular bodies wdiich secrete the Ear- 
wax are involved in all the diseases of the lining 
of the Auditory Canal. As already observed, 



AND PREVENTION. 53 

their secretion is suspended upon the appearance 
of inflammation, whether acute or chronic, of the 
External Canal, but they sometimes become more 
specially affected. After bathing, exposure to 
cold or draughts of air, or through the effect of 
the sudden repression of perspiration, they be- 
come inflamed and secrete too large a quantity of 
wax, which then blocks up the Canal. Owing to 
the increased heat attendant upon inflammation, 
the watery part of the wax evaporates, leaving in 
the Canal the dry residuum known as 



Hardened Ear-Wt 



a:e. 



If allowed to remain for some length of time, 
the wax thus impacted will sometimes become 
nearly as hard as stone. Some persons, ignorant 
of the causes which produce this superabundance 
of wax, ascribe it to a want of cleanliness ; but 
this is a great mistake. 

While in a healthy condition, the Glands never 
secrete more wax than is required for the pur- 
poses of protection, and only when diseased, do 
they secrete too great a quantity. Ear-wax can 
never be washed out of the Ear, as no towel or 
sponge can, or should be, introduced far enough 
into the Ear to reach it. 



54 DEAFNESS I ITS CAUSES 

Although, in general, the presence of impacted 
wax can easily be seen by an examination, yet 
owing to the smooth and shiny appearance which 
it occasionally assumes, it has in some cases been 
mistaken for the Drum-head, even by experienced 
physicians. To be able to detect its presence, re- 
quires in many cases a keen practical eye, as well 
as a careful examination. The following case will 
serve as an illustration. 

An English gentleman, sixty years of age, 
consulted us in 1857 in regard to his deafness. 
He had been affected five years, could not hear 
the ticking of a watch when placed on the bone 
back of the Ear, and could hear it but faintly 
when pressed upon the Auricle. He had to be 
very loudly spoken to, complained of constant 
noise and of occasional darting pain in the head, 
and had been examined by two Aurists of great 
repute in England, personally known to us, and 
by one physician of considerable celebrity in this 
country, who united in pronouncing his case to 
be one of nervous deafness, and incurable. 

Upon a close examination we discovered what 
appeared to be impacted wax, but the opinion ex- 
pressed by our predecessors caused us to doubt 
the evidence of our senses, until a still more crit- 



AND PREVENTION. 55 

ical examination fully assured us of its presence. 
In a few days the old gentleman, to his intense 
delight, was restored to good hearing, the chronic 
inflammation produced by the wax was removed 
by a few weeks' treatment, and the cure completed. 

Effects. — The hardened wax presses upon the 
lining of the Auditory Canal, causing that to be- 
come irritated and inflamed ; if pressing on the 
Drum-head, it produces inflammation and even 
ulceration of that membrane ; noises in the Ear, 
headache, neuralgic pain in the face, and dizziness 
are apt to arise from this cause. 

Treatment.— cJmp&ction of wax is one of the 
difficulties, for the removal of which the syringe 
can be made useful. Sweet oil will soften the 
wax, and some injections of warm water will do 
the rest. Even the simple operation of syringing 
must be well understood to make it effectual, or 
in spite of the most frequent applications, the Ear- 
wax may remain, as will be seen by the following 
case. 

A merchant of this city applied to us, com- 
plaining of complete deafness in one Ear, to- 
gether with noises so disagreeable and incessant, 
that he was fearful of becoming insane from their 
effects. 



56 DEAFNESS : ITS CAUSES 

He begged of us to try and remove the noises, 
even if hearing could not be benefited, and stated 
that he had been under the care of three physi- 
cians, and that his Ear had been syringed by their 
directions for more than two months, without any 
benefit whatever. 

An examination of the Ear revealed, to our 
great surprise, the presence of impacted wax ; 
when stating this fact to him he could scarcely 
believe it, as he thought the injections would cer- 
tainly have removed any w T ax which might have 
been there. In twenty-four hours from the time 
he applied to us, the wax was not only removed 
and the annoying noises stopped, but the hearing 
completely restored. 

The operation of syringing has to be done 
properly and carefully. While syringing the 
Ear, it should be frequently examined, and the 
operation suspended as soon as the wax is re- 
moved, otherwise, the water thrown forcibly on 
the very delicate and already ' irritated Drum- 
head might have a very injurious effect. 

After the wax is removed, the Ear should be 
subjected to appropriate treatment, lest the diffi- 
culty might not only speedily return, but the irri- 
tation of the lining membrane of the Auditory 



AND PREVENTION. 57 

Canal be productive of serious consequences to 
hearing. 



EFFECTS ON HEARING. 

Inflammation of the Auditory Canal gives rise 
to granulations, polypoid tumors, and impacted 
wax, which, obstructing that tube, prevent the 
vibrations of air from reaching the Membrana 
Tympani. 



INFLAMMATION OF THE MEMBEANA 
TYMPANI. 

The Drum-head being covered on its external 
surface by a continuation of the lining of the Au- 
ditory Canal, and on its internal surface by the 
delicate mucous membrane of the Middle Ear, 
generally participates in the various affections of 
these parts ; occasionally however it becomes in- 
flamed itself, and then in turn extends the disease 
to the parts mentioned. 
3* 



58 DEAFNESS : ITS CAUSES 



Its Acute Form 

commences with, deep-seated pain in the Ear, 
either darting or throbbing, which is in some 
cases very severe, and is accompanied with dul- 
ness of hearing, noises in the ear, and by all the 
symptoms attendant upon inflammation, such as 
headache, fever, &c. In 

Its Chronic Form 

these symptoms are very often absent, except the 
dulness of hearing ; upon examination we fre- 
quently find the Drum-head considerably in- 
flamed, without any pain having been expe- 
rienced. 

The exciting causes are the same as those 
which produce diseases of the External Canal ; 
draughts of air, however, are most injurious to 
the Membrana Tympani. 

Its Effects on Hearing. 

Inflammation produces thickening of the 

Drum-head, ulceration, and ultimate perforation. 

The ulceration may proceed to such an extent 



AND PREVENTION. 59 

as to involve tlie loss of the entire membrane. 
Deafness in such cases arises either from the 
impaired vibratility of the Membrana Tympani ; 
or, if the entire membrane is destroyed, from im- 
perfect communication of the vibrations of the 
air to the Labyrinth. 



60 DEAFNESS I ITS CAUSES 



DISEASES OF THE MIDDLE EAR 

INFLAMMATION OF THE EUSTACHIAN TUBE. 

Throat-affections are very apt to involve the 
Eustachian Tubes, and by extending themselves 
further on, affect the Middle Ear. In rare in- 
stances the Tubes become affected through dis- 
eases of the External Ear extending themselves 
to the Tympanum, and affecting the Tubes from 
above downward. 

Symptoms. — During a heavy cold the hearing 
is more or less impaired, and sometimes feels quite 
stopped up, wdien all at once, during the act of 
blowing the nose, sneezing, or coughing, some- 
thing snaps in the Ear, and hearing is restored. 
This symptom may be repeated for years, the 
hearing being good whenever the throat is in a 



AND PREVENTION. 61 

healthy condition, but quite bad as soon as it is 
in the least inflamed, until finally, hearing will 
become permanently injured. 

Deafness arises in such cases either from par- 
tial obstruction or entire closure of the Eustachian 
Tube, (produced by the thickened state of the 
Mucous Membrane, or by the scars resulting from 
ulceration,) preventing the air from reaching the 
Drum. The sudden loss of hearing during active 
inflammation, and the subsequent equally sudden 
restoration, is caused by a small particle of har- 
dened mucous, temporarily obstructing the Tube, 
which, by the muscular effort made by coughing, 
sneezing, &c, is dislodged, when the air, rushing 
suddenly in, produces the snapping and restores 
hearing. 



62 DEAFNESS : ITS CAUSES 



INFLAMMATION OF THE TYM- 
PANUM. 

Inflammation of the Drum is frequently ex- 
cited by affections of tlie throat, which reach it 
through the Eustachian Tubes, or by diseases 
of the External Ear, which extend themselves 
through the Membrana Tympani. The functions 
of the Middle Ear are so important and the sev- 
eral parts so delicately constructed, that their 
slightest abnormal condition prevents good hear- 
ing, and diseases of this part of the Ear are the 
most frequent cause of deafness. 

Its Acute Form 

commences with feverishness, headache, loss of 
appetite and an excruciating pain in the ear, 
known under the name of ear-ache, which rises at 



AND PREVENTION. 03 

times to sneli a pitch as to produce delirium. In 
more or less time from the commencement of the 
disease, and during a paroxysm of pain, something 
is felt giving way in the Ear, and a discharge of 
matter makes its appearance, after -which the 
symptoms become milder. In some cases the 
inflammation attacks the brain, and death may 
be the consequence. The hearing, very soon 
after the appearance of the inflammation, be- 
comes greatly impaired, and is sometimes entirely 
lost. Although this disease is liable to occur in 
individuals of every age, children are the most 
frequently attacked by it. Iso time should be 
wasted in procuring medical assistance, and if 
that cannot be obtained as soon as the urgency 
of the case requires, let the following treatment 
be at once commenced : 

Let the bowels be well moved by an active 
cathartic, such as Salts and Senna or Castor-oil, 
and apply from two to four leeches around the 
edges of the External Canal, or from six to eight 
around the Ear. The black spots in the accom- 
panying illustration will show, how they can be 
applied to the best advantage. The application to 
the edges of the canal is preferable, but before 
applying them to that part, a little cotton should 



64: 



DEAFNESS : ITS CAUSES 




be put into the Ear, to prevent the leeches from 
crawling in too far, or the blood from running 
into it. Should it be impossible to procure 
leeches, let the Ear be kept warm by warm 
bread-and-milk poultices, or by directing into the 
Ear the steam arising from the following mixture : 



Laudanum 

Tincture of Belladonna, 

Water, . 



1 ounce, 
1 ounce, 
J pint, mix. 



The best way to apply this, is by heating the 
mixture in a small tea-kettle, and then direct- 



AND PREVENTION. 65 

ing tlie steam issuing from the spout, into the Ear, 
taking care however not to have the steam so hot 
as to scald. 

In case the medicines above named cannot "be 
procured, the steam of water even will be found 
very beneficial. The reader must not imagine 
that the treatment recommended here is all that 
is required ; the advice is offered to allay the most 
distressing symptoms, and only until the services 
of a physician can be procured. The practice of 
pouring laudanum or of putting salt pork into 
the Ear as remedies for Ear-ache, is very injuri- 
ous and should be abandoned. 

Its Chronic Form. 

The chronic inflammation of the Middle Ear is 
by far the most frequent and the most dangerous 
disease of the ear, because it commences generally 
without any symptoms likely to attract attention 
until the hearing becomes so defective as to cause 
considerable inconvenience. Occasionally there is 
slight pain or a feeling of heaviness in the Ears 
together with noises, but in the majority of cases 
even these symptoms, with the exception of the 
noises, are absent. Persons laboring under this af- 
fection are scarcely if ever able to tell, when or 



66 DEAFNESS : ITS CAUSES 

how it commenced, and only recollect that they 
first noticed a slight defect in hearing after a se- 
vere cold, on having their attention drawn to this 
circumstance. The following is the usual state- 
ment obtained from that class of patients, and will 
serve to illustrate the symptoms : 

During a heavy cold a slight pain was expe- 
rienced in the Ear, especially when moving the 
jaws, and the hearing was a little thick or even 
considerably impaired, when during the act of 
sneezing or coughing, a crackling sound or a 
sharp report was heard in the Ear, sometimes 
loud enough to startle them, which was imme- 
diately followed by a return of hearing. 

This state of things was considered a natural 
consequence of a cold, and nothing was thought 
of it, until becoming thus affected at every subse- 
quent cold and upon the slightest exposure, they 
at last find their hearing to have become so much 
impaired, as to oblige them to seek relief. 

Causes. — Scarlet Fever is usuallv the exciting 
cause of the acute inflammation, and the common 
sore throat or catarrh, the .exciting cause of the 
chronic one. Both forms may be excited however, 
by all those causes operating unfavorably on the 
Ear, such as cold, acrid applications, &c, &c. 



AND PREVENTION. 67 

Its Effects on Hearing. 

Inflammation of the Tympanum, by producing 
a thickened state of the mucous membrane, dimin- 
ishes the size of that chamber, which in its normal 
state is not larger than a coffee-bean. The quan- 
tity of air necessary to the vibration of the Drum- 
head and for the communication of the vibrations 
to the Fenestra Rotunda is correspondingly re- 
duced in quantity. The peculiar secretion thrown 
out so abundantly by the diseased mucous mem- 
brane, tends still further to diminish the size of 
the Drum, and to exclude a still further portion 
of the necessary air. 

The small bones of the Ear being covered by 
the mucous membrane, are, by its thickened con- 
dition, as well as by the diminution of the size of 
the Drum, prevented from acting with that free- 
dom and precision, necessary for so delicate a 
mechanism. Bands of adhesion (similar to the 
false membranes produced by croup) are some- 
times formed by the inflammation between these 
little bones and the walls of the drum, and their 
action becomes still further impeded. 

Deafness then, in such cases, is owing to the 



68 DEAFNESS I ITS CAUSES 

imperfect or interrupted communication of the 
vibrations of the Drum-head to the Labyrinth. 



NERVOUS DEAFNESS, 

or deafness arising from diseases of the Nervous 
Structure of the Ear, is rare ; although formerly 
nearly every case of deafness in which no disease 
was observed in the External Ear, was pronounced 
" Nervous Deafness " for the sake of convenience. 
Since it has been demonstrated however, by sci- 
entific investigations, that in the majority of cases 
the loss of hearing results from diseases of the 
Middle Ear, " Nervous Deafness " has decreased 
wonderfully. 

The Auditory Nerve like other nerves is liable 
to diseases, such as Atrophy or shrinking, Paraly- 
sis, &c. 

Symptoms. — Loss of hearing, which in some 
instances takes place suddenly, and in others so 
gradually that its commencement or progress 
can scarcely be noticed. Noises of almost every 
imaginable character are generally present. At 
times there is a little darting pain through the 



AND PREVENTION. 69 

Ears, but usually it is absent. Symptoms of 
other nervous disorders are very often present, 
sucli as pains in the back of the head, neuralgic 
pains in the face, twitching of the muscles of the 
face, &c. 

Causes, — Paralysis or Atrophy of the Audi- 
tory Nerve, congestion, inflammation or softening 
of the brain, inflammation of the Middle Ear ex- 
tending to the Labyrinth, Typhoid fever, loud re- 
ports or very sharp and shrill sounds, falls or blows 
upon the head, and the action of quinine. 

Deafness is occasionally produced by tumors in 
the brain, but as a matter of course the existence 
of such bodies can only be ascertained by a Post- 
Mortem examination. 



OTALGIA, OR NERVOUS EAR-ACHE. 

In conjunction with toothache, a very distress- 
ing pain in the Ear makes sometimes its appear- 
ance, on account of the intimate nervous connec- 
tion between the Ear and Teeth. The removal 
of the carious tooth will cause a cessation of the 
ear-ache. 



70 DEAFNESS : ITS CAUSES 



OTORRHCEA, OR DISCHARGE FROM 
THE EAR. 

Discharge from the Ear does not constitute a 
disease, but is the sequel of disease of either the 
External or Middle Ear. It occurs so often, is 
so detrimental to hearing, so pernicious to the 
general health, so disagreeable in its character, 
and so very generally neglected, that it is neces- 
sary to devote a special chapter to its considera- 
tion, in order to have its true bearing fully under- 
stood. 



ITS CAUSES. 

Acute or sub-acute inflammation of the Middle 
or Exernal Ear, invariably terminates with dis- 



AND PREVENTION. 71 

charge ; but its most prolific source is Scarlet 
fever, this being the exciting cause in fully two- 
thirds of all the cases. 



ITS PROGRESS. 

The discharge, appearing immediately after the 
subsidence of an acute inflammation, is usually 
thin, scanty and mild in its character ; but if al- 
lowed to run into a chronic state, it becomes pro- 
fuse, very acrid and irritating, assuming an odor 
so highly offensive that even the patient's nearest 
friends become disgusted with it ; very often 
mothers, overcome by the dreadful stench, are 
unable to attend to their children, keeping away 
from them as much as possible. Children affected 
with it are very often prevented from attending 
school, because nobody wants to sit near them, 
and this renders them sensitive, morose and irri- 
table. Adults being themselves aware of the sick- 
ening smell usually shun company as much as 
possible, so as not to give offence. 



72 DEAFNESS : ITS CAUSES 

ITS DANGER TO THE EAR. 

The discbarge is very acrid, its presence there- 
fore tends to increase and extend the inflammation. 

If proceeding from the Middle Ear, the Drum- 
head must have been perforated by the inflamma- 
tion which gave rise to the discharge in the first 
instance ; sooner or later, the Drum-head will 
slough off entirely, and even the small bones 
will, one after another, be lost. They are fre- 
quently found amongst the discharge by the pa- 
tients or friends, and shown as something strange 
that came away from the Ear. 



ITS DANGER TO LIFE. 

The inflammation, fostered by the irritating 
discharge, is liable to extend itself through the 
opening of the vestibule into the Labyrinth, and, 
attacking the nervous structure, produce chorea 
or St. Vitus's dance, neuralgic pain in the face 
and head, dizziness, and a host of other nervous 
derangements. In time, it may attack the sur- 
rounding bony structure and produce caries or 



AND PREVENTION. 73 

ulceration. The upper wall of the Middle Ear, 
being very thin and delicate, when thus affected 
is easily eaten through, the membranes of the 
brain being then exposed become inflamed, as also 
does the brain itself, when convulsions and death 
will be the inevitable result. The internal car- 
otid artery, the largest artery of the head, is in 
close contiguity to the Labyrinth, and should the 
ulcerative process attack the bony canal through 
which it runs, it may perforate it, and fatal hae- 
morrhage would ensue. All these results may 
occur even in cases where the discharge at first 
proceeded merely from the external canal, and 
where it existed for years, without much apparent 
injury; for a slight cold, or a draught of air, is 
liable at any moment to aggravate the existing 
symptoms to such an extent, as to render any of 
the above-named fatal issues possible. We have 
Life-Insurance-Companies, who understand the 
danger arising from this disease so well, that they 
either altogether refuse to insure applicants 
afflicted with it, or insure them at a greatly ad- 
vanced rate. 

We are confident that, could statistics be ob- 
tained of the average length of life of those who 
4 



li DEAFNESS I ITS CAUSES 

suffer from this disease, startling facts would be 
revealed in regard to its fatality. 



IRRATIONAL IDEAS CONCERNING ITS REMOVAL. 

It would appear strange indeed that a disease 
so easily observed, and so repulsive to the senses 
both of smell and sight, should be so much neg- 
lected and so generally left alone, but for the fact 
that so many queer and unreasonable notions ex- 
ist in regard to it. In the first place the suppo- 
sition is, that it may get well of itself, or that 
in the case of children it may be outgrown ; 
then the opinion is entertained by many, that 
it is altogether incurable, whilst a further and the 
most unreasonable supposition is, that it serves as 
a drain for the bad humors of the body, and its 
suppression might be followed by some other and 
more dangerous disease. 



THE REFUTATION OF THESE POPULAR FALLACIES. 

It is true that Nature exerts herself most gen- 
erally for the restoration of health, and that a 



AND PREVENTION, 75 

physician has only to direct her powers judiciously, 
in order to effect a cure. But in diseases of the 
Ear, Nature does but little and leaves it in a great 
measure for Art to supply her place, owing to the 
fact already stated under the head of the causes 
of aural diseases, that the Ear is surrounded by 
bony structure only, and has but a very feeble 
circulation. There are but very few cases of dis- 
eases of the Ear on record, getting well of them- 
selves, and while one mild case might do so, hun- 
dreds of others not only remain so, but grow worse. 
How little the power of Kature is exerted in dis- 
eases of this organ, is shown abundantly by the 
fact, that the powerful revolution produced in the 
system at the time of puberty, effects not the 
slightest improvement in them, although diseases 
of the Eye and other organs disappear under its 
influence, as if by magic. By entertaining the 
false hope of obtaining relief from nature and 
time, the future happiness of many a child is im- 
perilled. 



THE NECESSITY OF A SYSTEMATIC TREATMENT. 

To remove discharge from the Ear requires a 
systematically instituted treatment, which has to 



76 DEAFNESS I ITS CAUSES 

be patiently carried out, in some cases over the 
space of years. Physicians engaged in general 
practice, either disliking to treat a disease so dis- 
agreeable in its nature, or if treating it, finding 
their patience exhausted before much improve- 
ment is effected, are very prone to pronounce it 
incurable, with a desire to get rid of the patient, 
or because of their own limited experience in the 
matter. This indifference or want of success on 
the part of the general practitioner, has established 
to some extent the idea of its incurability. 

We are happy to be able to disabuse our 
readers of so erroneous an impression, as frojn our 
own practice, we could cite many cases of dis- 
charge from the Ear of long standing and in all 
its progressive stages, which have been radically 
cured. 



THE BENEFITS RESULTING FROM ITS REMOVAL. 

The danger arising from the removal of dis- 
charge exists only in the imagination, but not in 
reality ; while the danger of its presence is a 
fixed and incontrovertible fact. Inflammation 
cannot exist long in any part of our body without 



AND PREVENTION. 77 

doing more or less injury ; but when it exists in 
an organ situated in such close proximity to the 
brain, and is accompanied by an acrid discharge, 
liable to be absorbed again into the system and 
create diseases elsewhere, the injury it produces 
must be the more certain and severe. In order to 
remove the discharge permanently, the inflamed 
surface from which it emanates must be restored 
to a healthy condition, and from such a course 
the system, instead of being injured, cannot but 
be benefited, and the danger of its creating other 
diseases averted. Instead of carrying off the bad 
humors of the blood, discharge detracts from the 
nutrition of the body, and those affected with it 
present generally a puny and sickly appearance. 

Until competent treatment can be obtained, let 
the Ears be syringed out occasionally with simple 
warm water. The syringing should be done 
gently, however, lest the inflamed surface would 
be still more irritated, and should not be repeated 
oftener, than is absolutely necessary for the pur- 
poses of cleanliness. The attempt to clean the 
Ears with cotton is to be condemned, as it is in- 
effectual to remove the discharge from the bot- 
tom of the canal where its presence does the most 
harm, and is more irritating than the syringing. 



78 DEAFNESS I ITS CAUSES 



THE CAUSES OF THE FREQUENCY 
OF DEAFNESS. 

The extent to which deafness prevails, in one 
Ear or both, from the non-appreciation of faint 
and low sounds to the total loss of hearing, is far 
greater than is generally supposed. Those whose 
hearing becomes impaired, are astonished at find- 
ing so many whose condition is similar to, or 
much worse than their own. 

This is owing in a great measure to the cul- 
pable neglect of people to seek competent medical 
advice upon the appearance of the first symptoms 
of a disease in the ear, or to improper and irra- 
tional treatment. The majority of diseases of the 
Ear are chronic, commence very insidiously, give 
no pain, and impair hearing so gradually that in 



AND PREVENTION. 79 

the first stages their presence is scarcely if ever 
detected. 

Deafness is hardly ever perceived or acknowl- 
edged, until great difficulty is experienced in hear- 
ing common conversation, and when it reaches 
this degree it is already much, impaired, and the 
disease from which the difficulty proceeds, must 
have progressed to a considerable extent. 

A slight defect in hearing is not likely to be 
noticed, because persons so affected are apt, at 
first, to ascribe their inability to hear common 
conversation readily, either to their own careless- 
ness, or to the indistinct articulation of those with 
whom they converse. 

Their own supposed fault, they endeavor to 
remedy by the most eager listening while en- 
gaged in conversation, as well as by watching 
the movements of the lips of the one w T ho ad- 
dresses them; who perceiving himself frequently 
misunderstood, will speak more distinct or raise 
the voice a little. 

This mutual accommodation prevents, for a 
time, the knowledge of the real source of the dif- 
ficulty. As the idea of existing deafness is a deli- 
cate matter to broach to any one, it is scarcely 



80 DEAFNESS : ITS CAUSES 

ever acknowledged until it is too marked to be 
longer concealed. 

Children are very often punished for stupidity 
or laziness, when their supposed inattention is in 
reality a disability to hear. In some cases such 
undeserved punishment is continued persevering- 
ly, until by an accident the mistake is rectified, 
and the child's hearing will not only be found 
affected, but its temper as well. 



PROCRASTINATION. 

But even after the fact of existing deafness is 
recognized, a long time is allowed to elapse, in 
most cases, before the physician is called on for 
advice. 

At first, good old Dame Nature is relied on, 
to set all things right, but for the reasons stated 
under the head of Otorrhoea, she refuses to extend 
her beneficent influence to the organ of hearing, 
and hinders children in this way from outgrowing 
diseases of the Ear, no matter how hard and dili- 
gent they may try to do so. 

Being disappointed by nature and time, home 
remedies are usually brought into requisition and 



AND PREVENTION. 81 

faithfully administered under the direction of 
some Sage Old Lady, who is positive that great 
benefit will be derived from this herb or that de- 
coction. 

Receiving no help in spite of persevering 
trials, nostrums well advertised, highly praised 
and warranted to effect a cure, are resorted to 
until, their inefficacy or injuriousness having 
been sufficiently demonstrated, the medical man 
is called on after much time and hearing has been 
lost. 



EMPIRICAL TREATMENT. 

The Family Physician is generally consulted 
first, but we are sorry to be obliged to confess, 
that the majority of them are not so well in- 
formed in regard to diseases of the Ear as they 
should be, and as the importance of this organ 
demands. Physicians, well-informed on any other 
subject, ranking deservedly high for their learn- 
ing, skill, and judgment in medicine and surgery, 
who would not prescribe for a simple case of head- 
ache without an examination as to its cause, have 
not the least hesitancy to prescribe for a case of 
4* 



82 DEAFNESS I ITS CAUSES 

deafness, without as much as an examination of 
the Ear. 

Remedies are still extensively prescribed, 
which have been recommended and used at a 
time when Physiology and Pathology were in 
their veriest infancy ; when even the most im- 
portant causes of deafness were unknown, and 
the External Canal seemed to have been con- 
sidered specially created, as a receptacle for all 
kinds of liquid applications. 

There are still practitioners who drop or syr- 
inge into the Ear, sweet oil, soap-suds, glycerine, 
as well as such acrid substances as Tincture of 
Cantharides or Tincture of Capsicum, without 
stopping to reflect whether the application or- 
dered, is adapted for the case under consideration. 
Finding their efforts not followed by the much- 
desired success, and observing the hearing becom- 
ing worse and worse as treatment is continued, they 
very often come to the conclusion that deafness can- 
not be cured, that the Ear is too delicate an organ 
to be meddled with, and had better be left alone. 

The public receiving so little encouragement 
from the profession, try to obtain help from what- 
ever source it is promised. Quacks, Charlatans 
and self-styled Aurists, without any medical edu- 



AND PREVENTION. 83 

cation whatsoever, duly improve the opportunity. 
If their ever-ready promises or their glowing 
advertisements, would be able to effect cures, 
there would not be many deaf people in ex- 
istence ; not only do they fail, however, to per- 
form what they promise, but they generally make 
the disease even worse than they find it. 

Some of the applications of these medical 
mountebanks are of the most painful character, 
and produce severe injury. Two cases were 
brought under our notice : one of a young lady 
from the interior of this State, who became 
insane from such a severe application, and who 
is an inmate of a lunatic asylum up to date ; and 
that of another lady, subjected to similar treat- 
ment, who was only saved from sharing a similar 
fate, by the most prompt and active treatment. 

It would be unfair, indeed, if we were to in- 
clude the whole medical profession in the remarks 
we have made, for physicians high in rank and 
of thorough scientific acquirements, aided by the 
advanced state of medical science of the present 
day, have used every effort to ascertain the causes 
which produce deafness, by dissecting the ears of 
those, who during life had been deaf. They 
brought the diseased parts under the microscope, 



84 DEAFNESS I ITS CAUSES 

the magnifying power of which assisted them in 
the elucidation of its pathology, and they then de- 
voted their time and attention, for the purpose of 
ascertaining the best means, for the successful 
treatment of its various diseases. By publishing 
the result of their patient and laborious investiga- 
tions, they have aroused the interest of the pro- 
fession for Aural Surgery, this highly important 
though hitherto much neglected branch of medical 
science ; and although much is still to be desired, 
the good fruit of their labor is already discern- 
ible, and we trust the day may not be far distant, 
when every medical man will be as capable to 
prescribe for a diseased ear as for disease of any 
other organ. 

In order to acquire the ability to discriminate 
correctly between the different diseases of the ear, 
to detect their presence and locality readily, to 
select and institute for them their appropriate 
treatment, and to become possessed of the deli- 
cacy of touch and dexterity of hand necessary for 
its manipulation, a far larger number of cases is 
required, than ordinarily falls to the share of any 
general practitioner ; therefore, in all countries, 
some medical men having a taste and aptitude 
for this branch, devote their special attention to 



AND PREVENTION. 85 

it, and become able through their extensive ex- 
perience to obtain better results. 

An aurist must not only be conversant with 
all that appertains to the ear, but be a well- 
educated physician and surgeon. 



86 DEAFNESS : ITS CAUSES 



THE RATIONAL TREATMENT OF 
DEAFNESS. 

Deaexess being not a disease itself, but the ef- 
fect of disease, can never be cured by any specific 
remedy, or by any one operation. A remedy 
which acts beneficially in one case, may produce 
decided injury in another, even when the symp- 
toms in both cases, appear to the uninitiated to be 
identical, for the deafness may proceed from causes 
diametrically opposed to each other. Therefore 
all nostrums or single operations, advertised for 
the cure of deafness in all its stages and various 
forms, have proved and ever will prove miserable 
failures. 

To treat deafness successfully, the treatment 
should be directed to the cause which produces 



AND PREVENTION. 87 

it, on the same principle on which every other 
disease is treated. Besides the constitutional 
treatment in a majority of the diseases of the Ear, 
we have the additional advantage of making local 
applications with decided benefit. 



REMEDIAL AGENTS. 

In cases of inflammation of the External Ear, 
remedial agents put into the Auditory Canal, by 
coming in direct contact with the diseased surface, 
will be found useful. In diseases of the Middle 
Ear, however, where the Membrana Tympani is 
integral, applications to the External Ear are not 
only of no use, but may prove injurious. 

Local applications can reach the Tympanum 
only through the Eustachian Tube, the same chan- 
nel by which diseases of the throat are communi- 
cated to that part of the Ear. These applications 
are made by introducing a catheter through the 
nose into the Eustachian Tube. The following 
cut will illustrate the operation. 

The introduction of the catheter, formidable as 
it may appear, is a very simple process, and if 



88 



DEAFNESS : ITS CAUSES, ETC. 




done by an experienced hand is not attended with 
any pain or inconvenience. Liquids, vapors, or 
air can thus be introduced into the Middle Ear. 

In chronic diseases of the Middle Ear, com- 
pressed air and liquids of various kinds have been 
extensively used in this manner, but being fre- 
quently disappointed in their effects, and finding 
them too irritating for the delicate lining of the 
Middle Ear, we have adopted with the best of re- 
sults 

A NEW METHOD OF TREATMENT, 



for this so frequent class of affections, consisting 
in the introduction of gases and warm vapors, im- 
pregnated with such medicinal substances as the 
particular case requires. 



90 



DEAFNESS I ITS CAUSES 




THE AUTHOR'S METHOD OF APPLYING WARM YAPORS TO THE MIDDLE EAR. 

The wooden stand upon which the apparatus is placed, contains a powerful 
Air-Pump. The liquid contained in the bottle having been properly heated, the 
cold air from the pump is forced into it through the India-rubber tube. A warm 
vapor is thus produced which, finding no other outlet, is forced into the tube con- 
nected with the Catheter, and is thus made to enter the Middle Ear. 



AND PREVENTION. 91 

For tliis purpose we have constructed an appa- 
ratus of which the accompanying cut is a correct 
illustration. 

These vapors come in direct contact with the 
diseased mucous membrane of the Eustachian 
Tube and Middle Ear, and bring it to a healthy 
condition. As the vapors are warm, they do not 
lower the temperature of the Ear, and conse- 
quently feel grateful to that organ. Local ap- 
plications can never be exclusively relied on, how- 
ever, for the cure of disease of the Ear ; constitu- 
tional treatment has always to be combined with 
them. 

To cure deafness permanently, the causes 
which excited the disease of the Ear must be 
removed. In cases where Chronic Catarrh in the 
head, or inflammation of the throat has been the 
primary cause, the mucous membrane of these or- 
gans must be brought to a healthy state, for their 
diseased condition would furnish a constant source 
for relapse. 



THE CURABILITY OF DEAFNESS. 

The curability of deafness does neither depend 
on the age of the person affected, nor on the de- 



92 DEAFNESS : ITS CAUSES 

gree of deafness, but on the source from which 
it emanates. That deaf persons of great age, as 
well as those who can scarcely hear a sound, can 
at times be restored to good hearing, will be seen 
by the following case, which is only one of a 
great number of similar ones that have occurred 
in our practice. 

J. "Williams, an old gentleman from Sussex 
County, N". J., consulted us, in the summer of 
1859, in regard to his 'case. He was so deaf that 
he could not understand conversation carried on 
in the loudest voice, even if the speaker's mouth 
was in contact with his ear ; consequently, writing 
was the only medium of communication. He 
frankly said that he did not expect any benefit, 
and only came at the earnest solicitation of his 
friends. Discouraging as his case certainly ap- 
peared to both him and us, after a short course 
of treatment his hearing was restored to such a 
degree, as enabled him to hear common conversa- 
tion with perfect facility. 

A case mentioned in a recent work on the Ear 
by Dr. Yon Troltsch, a German author of high 
repute, is also worthy of recital : 

An engineer on one of the German railroads 
became so deaf, that he could not hear the work- 



AND PREVENTION. 93 

ing of the locomotive, and could hardly hear con- 
versation in the loudest voice, even when ad- 
dressed to him through an ear-trumpet. He con- 
sulted the author, and after but a few applications 
was enabled to hear conversation readily, without 
the aid of the trumpet. 

Many more cases could be cited, from our own 
practice and that of others similar to the preced- 
ing, but those mentioned are sufficient to show that 
however desperate a case may appear, there is a 
possibility of its being relieved, and consequently 
an examination should be had in all cases before 
hope is given up. 



94 DEAFNESS *. ITS CAUSES 



THE PKEVENTION OF DEAFNESS. 

Deafness being caused in consequence of dis- 
eases of the Ear, those who value their hearing, 
and desire to prevent so great a calamity as to 
lose it or have it impaired, should be careful to 
maintain the health of that organ, and guard it 
against all influences likely to prove injurious. 

The following suggestions will aid those so 
disposed, to accomplish this object : 



cleanliness. 



The Ears ought to be kept in a state of clean- 
liness by washing them every morning. The 
sponge used for this purpose should be soft and 



AND PREVENTION. 95 

the water lukewarm, nor should any attempt be 
made to force the sponge into the Ear, as it 
might create an irritation and inflammation of 
the Auditory Canal. 



PROTECTION AGAINST COLD. 

The Ears should be well protected against 
cold, as its depressing influence is the cause of 
a large proportion of its diseases. During cold 
and stormy weather they ought to be covered, 
and for that purpose caps with, ear-flaps attached 
should be worn. Less deafness exists among fe- 
males than males, because the ears of the former 
are protected by hoods and bonnets, while those 
of the latter are usually exposed. 

Draughts of air, either in the house, the sleep- 
ing apartment, the carriage or railroad car, should 
be carefully avoided. Nurses ought never to 
dress young children near an open window, or 
opposite a crack or opening, and if carried out 
in cold weather a child's ears should be well cov- 
ered. 



96 DEAFNESS I ITS CAUSES 



PRECAUTIONS IN BATHING. 

While bathing, a little cotton, saturated with 
oil, should be put into the Ears, to prevent the 
water from running into them, especially when 
diving. As the pellet of cotton is liable to be 
washed out by the action of the water, as a fur- 
ther precaution an oiled silk cap should be tied 
over the head, to prevent such an accident. 



V 



WARNING AGAINST EAR-SPOONS. 



Digging into the Ears with Ear-spoons, knit- 
ting needles, or hair pins, is not only indelicate,, 
but very injurious, as it is very often productive 
of chronic inflammation of the lining of the Ex- 
ternal Canal, and should therefore be avoided. 
It might be supposed that the sharp and darting 
pain, occasionally experienced by persons indulg- 
ing in this practice, would be sufficient, to warn 
them of the danger to which a continuation of 
it, would be liable to expose them ; but habit most 
generally overpowers prudence, and such articles 



AND PREVENTION. 97 

as those mentioned, are thrust into the Ear again 
and again, until hearing becomes impaired. 



PUNISHMENT OF CHILDREN. 

The practice of pulling or boxing children's 
Ears as a means of punishment, deserves a severe 
rebuke, as it might be productive of very serious 
consequences to hearing ; cases have come under 
our notice where the Drum-head has been rup- 
tured by a box on the Ear, and when diseases of 
the nervous structure of the Ear followed such 
irrational punishment. 



ADVICE TO ARTILLERISTS. 

The means by which the effects of loud re- 
ports can best be counteracted or lessened, is by 
condensing the air in the Middle Ear, so as to 
enable the Drum-head to protect the Auditory 
Nerve from receiving an injurious shock, by offer- 
ing the greatest possible resistance to the pres- 
sure produced by the concussions. To accom- 
5 



VO DEAFNESS : ITS CAUSES 

plisli this object, gunners have heretofore been 
advised to keep the mouth wide open, for the 
purpose of facilitating the entrance of air into 
the Middle Ear through the Eustachian tubes. 
Without the exercise of some force, however, no 
more than the usual quantity of air is admitted, 
and consequently no advantage is obtained. 

The diver obtains temporary relief from the 
pain and dizziness he experiences while under 
water, by making an expiratory effort at the 
same time closing tightly his mouth and nostrils, 
thereby forcing the air from the lungs into the 
Tympanum. Gunners would find an imitation of 
this practice very serviceable while discharging 
heavy ordnance ; but as a row of soldiers holding 
their noses tightly with their fingers, would not 
present a very martial appearance, they should, 
while in the act of discharging their pieces, keep 
the mouth tightly closed and go through the act 
of swallowing, as by this manoeuvre the air is 
driven with sufficient force into the Middle Ear, 
to assist the Drum-head in warding off the shock, 
and to lessen materially the injurious effects of 
the reports. 



AND PREVENTION. 99 



PROTECTION OF THE FEET. 

The extremities should never be allowed to 
become cold or damp, or if so, to remain in that 
condition any length of time. The feet, espe- 
cially, should be well protected, and during cold 
or wet weather good woollen socks should be 
worn, and the boots or shoes should have thick 
soles ; when the streets are covered with slush or 
snow, the thickest soled boots hardly suffice to 
keep the feet from getting damp, and as an 
additional precaution India-Rubber over-shoes 
should be worn. If the feet become damp in 
spite of these precautions, they should be dried 
and warmed at the first opportunity, and after 
the usual temperature has been restored, a clean, 
dry pair of socks should be put on. 

Cold feet are the cause of many of the most 
prevalent and dangerous maladies, of which dis- 
eases of the Ear are but a part ; it is really sad to 
contemplate how many of our ladies, in order to 
make their feet look " nice " and small, wear 
shoes so tight as to impede the circulation of the 
blood, and with such thin soles, as to scarcely 
afford any protection whatever against the cold. 



100 DEAFNESS : ITS CAUSES 

For the past year or two, however, Prudence 
seems to get the better of Fashion, and we are 
happy to observe that at the present time a ma- 
jority of the American ladies are not ashamed to 
wear large, stout shoes, with good thick soles. 
This improvement in the covering of the feet will 
assuredly diminish, to a considerable extent, the 
number of invalids in the ranks of the gentle sex. 

Those habitually troubled with cold feet, should 
bathe them several times a week in warm water, 
rubbing them briskly with a coarse towel until 
dry, or if not too delicate, they may once a day 
put them into cold water up to the ankles, and 
then rub them briskly until perfectly dry and 
warm. 



RULES FOR THOSE PREDISPOSED TO COLDS. 

Many individuals have a constitutional tenden- 
cy to take cold on the slightest exposure or through 
the frequent changes of the atmosphere. They 
should endeavor to overcome it by daily sponging 
the neck and chest with cold water, then rubbing 
with a coarse towel until perfectly dry and a glow 
of the skin is produced. Very delicate individuals 
should have the water lukewarm at the commence- 



AND PREVENTION. 101 

ment of this prophylactic treatment, and gradually 
accustom themselves to using it cold, that the sys- 
tem may not receive too sudden a shock. 



NECESSARY CAUTION DURING ATTACKS OF INFLU- 
ENZA. 

Persons when affected with influenza — the 
disease usually called cold — should be careful of 
themselves, and guard against imprudent expo- 
sure, as the inflammation may extend itself to the 
Ear. In cases any way severe, the room, and 
even the bed should be kept, and a physician 
called. Too much caution cannot be exercised in 
regard to this disease, which may appear insig- 
nificant, but is capable of producing the worst 
consequences. 



RULES TO BE OBSERVED DURING ATTACKS OF SCARLET 
FEVER. 

Children, attacked with Scarlet Fever, should 
be closely watched, and their slightest complaint 
of noises or pain in the ears be at once reported 



102 DEAFNESS : ITS CAUSES 

to the attending physicians. In the case of very 
young children, who give evidence of pain, but 
are unable to indicate the locality of it, pressure 
should be made below the Ear, when the cause 
will be instantly revealed. While convalescent, 
they should be carefully guarded againt prema- 
ture exposure. 



MEASLES. 



This disease, although not attacking the Ears 
as frequently as Scarlet Fever, still requires the 
watchful care of parents and physicians, as it 
might become very destructive to hearing, either 
by propagating itself to the External Canal, or 
through the Eustachian Tubes to the Middle Ear. 
In either case the slightest symptoms should be 
met by appropriate treatment. 



SCROFULA. 



The Mucous Membrane of Scrofulous children 
is very tender and irritable. They frequently 
suffer with chronic sore throat, enlarged tonsils, 



AND PREVENTION. 103 

and inflammation of the lining of the nose, accom- 
panied by a constant discharge of matter or clear 
liquid from that organ, very often so acrid as to 
excoriate the parts with which it comes in contact. 
The edges of the nostrils and the upper lip are 
usually found sore and swollen. This condition 
easily predisposes the system to diseases of the Ear, 
and the utmost solicitude should be observed to 
guard these little sufferers against such a result. 

Their dress should be warm, but light ; their 
food substantial, but plain; they should have 
plenty of good air, and their sleeping apartments 
should, on that account, be well ventilated. In 
damp or wet weather they should be kept in- 
doors, or if obliged to go out, should be well pro- 
tected against dampness, as it is very injurious to 
them. During clear weather, even if cold, they 
can be in the street or the play-ground any rea- 
sonable length of time, and will be decidedly ben- 
efited by it. 

If the hearing of scrofulous subjects becomes 
impaired, it is done very gradually. The child 
will have spells when it cannot hear quite well, 
followed by others when the hearing is as well 
as ever. This condition is very apt to deceive 
parents, who think that the child will outgrow 



104: deafness: its causes 

the difficulty, until, during one of the spells when 
the hearing is impaired, they wait in vain for its 
customary return. 

It is then, and generally not until then, that 
parents become aware, that there is really some- 
thing the matter with the child's ears, requiring 
attention. 

Whenever the tonsils are found to be enlarged 
or the throat to be affected, the child should be 
put under proper medical treatment, as, by re- 
moving these affections, deafness will, in most 
cases, be prevented. 



foreign bodies in the ear. 

Occasionally it will happen, by some mishap 
or through mischief, that a foreign body, as, for 
instance, a bead or bean, or such like thing, will 
be introduced into the Auditory Canal. Children 
will sometimes play such tricks on each other 
while playing. 

A foreign body, if allowed to remain in the 
Ear for some time, will produce much pain and 
inflammation, of which deafness may be the ulti- 
mate result, though the alarm occasioned by such 



AND PREVENTION. 105 

an accident, is usually far greater than is war- 
ranted by the immediate danger, likely to accrue 
from it. Those unacquainted with the anatomy of 
the Ear, think even that the object will work its 
way into the brain, and produce death. 

The greatest danger arising to the Ear from 
such accidents, is produced by the bungling at- 
tempts so frequently made for the removal of the 
body introduced. In some cases, the Ear is most 
unmercifully poked into with all sorts of instru- 
ments, in spite of the struggles of the child, until 
the object is not only pushed further into the Ear, 
but serious inflammation is excited. Cases are 
on record, where inflammation of the brain was 
caused by such rough manipulations, and death 
resulted in consequence of it. 

The best thing to be done under such circum- 
stances, is to take the child to as good a physician 
as can be found, w T ho, with appropriate instru- 
ments, will soon remove the offending body, and 
administer an anesthetic to prevent all suffering, 
should the child be timorous, or the operation 
likely to be painful. In case the services of a 
physician cannot be procured as soon as desir- 
able, the following directions for their removal 
will be found useful : 
5* 



106 DEAFNESS : ITS CAUSES 



DIRECTIONS FOR THEIR REMOVAL. 

Draw the Ear upwards and outwards to 
straighten the Canal as much as possible, then 
direct the child to incline the head to the side 
of the affected Ear, until it reaches a horizontal 
position, when, by gently shaking the head, the 
object, if not too large, will generally drop out. 
Should this not have the desired effect, throw 
some lukewarm water with a syringe into the 
Ear, and the body may be carried away with the 
reflux. The water should not be syringed in 
straight, lest, by hitting the object directly, it 
might drive it still further into the Ear, but 
should be directed more towards the walls of 
the Canal. 

"Whilst syringing, the child's head should be 
inclined a little to the side affected, so that the 
exit, of both the water and the object, may be 
facilitated. 

Should the foreign body be of a porous 02 
spongy nature, (which absorb fluids quickly,) 
the use of water is inadmissible, as it would in- 
crease the bulk of the object, and increase the 
mischief in consequence. To get rid of live in- 



AND PREVENTION, 107 

sects which enter the Ear, the Canal should be 
filled with warm water or warmed sweet oil, 
which will quickly destroy them. 



DEAFNESS IN ONE EAR. 

A great many persons affected with deafness 
in one Ear, exhibit the greatest carelessness in re- 
gard to it, entertaining the idea that Nature is 
kind enough to recompense them for the loss 
they sustained in one Ear, by doubling the 
power and usefulness of the other. They appear 
to disregard entirely the strong and unmistakable 
sympathy existing between two organs, whose 
functions are identical, and seem to forget that 
the causes w T hich produced disease in the one 
Ear, may at any time operate unfavorably on the 
other. 

Although, in some cases, deafness exists for 
years in one Ear, while the hearing in the other 
remains perfect, yet the liability of its becoming 
affected is ever present, and the slightest cause 
may produce the unwelcome result. With but 
very few exceptions, the sound Ear will, sooner or 



108 deafness: its causes 

later, be attacked ; there are but few cases on 
record, of persons who have been deaf in one Ear, 
going through life without becoming deaf in the 
other also. 

The greatest caution should be exercised by 
such persons, to guard as much as possible 
against all influences, apt to operate unfavor- 
ably on the Ear. The deaf Ear should, by the aid 
of medical treatment, be brought to a healthy 
condition, even if its hearing could not be re- 
stored, for its diseased state, furnishes a constant 
source of danger to its healthy companion, and 
should be removed with the least possible delay. 



AND PREVENTION. 109 



SYMPTOMS OF DISEASES OF THE 
EAR. 

In spite of all precautions, the Ear will at 
times become affected ; but even then, deafness can 
in many cases be prevented, if suitable treatment 
is instituted in the primary stages of the disease. 
It will be remembered that the diseases most de- 
structive to hearing, commence very insidiously, 
without pain, noises, or any symptoms calculated 
to alarm the patient, and that hearing becomes 
impaired so gradually, that no disease is suspected 
until the inability to hear common conversation, 
establishes the fact of deafness. 

It is most important, therefore, to be able to 
detect the slightest defect in hearing, and I would 
advise the following method for that purpose : 



110 DEAFNESS I ITS CAUSES 



METHOD OF DETECTING INCIPIENT DEAFNESS. 

As soon as the least difficulty is experienced 
in hearing a whisper, or conversation carried on 
in a low tone, or when children have to be called 
or addressed several times before they pay any 
attention, the state of hearing should be tested in 
the following manner : 

Let some one hold an ordinarily loud ticking 
watch, six feet from the Ears, and if the ticking 
cannot be heard readily at that distance, it may 
be taken for granted there is something wrong 
about the Ear which requires looking after, that 
does not admit of delay. This procedure will at 
once enlighten the mind of the adult as to the cor- 
rect state of his hearing, and will, we trust, be the 
means of saving children undeserved rebuke or 
punishment, as well as afford parents an oppor- 
tunity to have the difficulty attended to in time. 



EAR-ACHE, 



whether dull or violent, darting or throbbing, is 
always an evidence of a diseased condition of the 
Ear, and calls for a careful examination and suit- 



AND PREVENTION. Ill 

able treatment. To avert danger to hearing, the 
causes which produce the pain must be removed, 
and this cannot be done by attempts so frequently 
instituted, merely to quiet the pain. 



NOISES. 



Noises in the Ears of whatever nature, whether 
resembling the roar of the ocean, the hissing of 
steam, the ringing of bells, or other sounds, are a 
sure indication of some abnormal condition, and 
their warning voice of impending danger to the 
hearing, should be faithfully and quickly obeyed. 



DISCHARGE FROM THE EAR. 

A slight discharge from the Ears will some- 
times be noticed without any marked symptoms of 
disease having preceded it. Whenever this is the 
case, no time should be lost to have the Ears ex- 
amined and the causes from which it emanated 
removed. The discharge, when appearing under 
such circumstances, proceeds from some mild form 
of inflammation of the Auditory Canal, which 



112 DEAFNESS I ITS CAUSES 

can easily be removed if remedies are applied 
in time, but which, if allowed to go on, might 
produce the most serious effects. 



WARNING AGAINST PROCRASTINATION. 

As the spark which causes a conflagration 
destructive enough to lay a whole city in ashes, 
can be extinguished by the pressure of a finger, 
and the mighty avalanche, which crushes every 
thing in its course and buries whole villages 
under its ponderous masses of snow, could be 
arrested at its starting-point by the intervention 
of a hand, so the inflammation which causes an 
incurable deafness, can most generally be removed 
by but a few weeks' treatment, and all danger to 
hearing averted, if attended to in time. No de- 
lay, therefore, should be allowed to occur, in pro- 
curing medical assistance as soon as the slightest 
morbid condition of the Ear becomes manifest. 



CAUTION AGAINST EMPIRICAL TREATMENT. 

Let the reader beware of tampering with the 
Ear, by resorting to nostrums or by attempting to 



AND PREVENTION. 113 

be his own physician, nor delay procuring treat- 
ment on the ground of not having a professed 
Aurist within reach. Any well-educated physi- 
cian is able to give better advice than a non- 
professional person, and may at least be able to 
arrest the progress of the disease, until the ser- 
vices of an expert can be obtained. 

Physicians, however, who prescribe for deaf- 
ness at random, and without a previous exami- 
nation of the affected Ear, should be avoided, as 
unfit for the office of medical adviser in such 
cases. 



114 DEAFNESS : ITS CAUSES 



REVIEW OF SOME OF THE POPU- 
LAE REMEDIES FOR DEAFNESS. 

Great reliance appears still to be placed, on 
some popular remedies for the cure of deafness, 
and it is very seldom indeed, that patients apply 
to ns who have not previously used one or another 
or sometimes several of them, for a greater or less 
extent of time, in order to obtain the expected re- 
lief. Only after being repeatedly disappointed, do 
they think of obtaining regular medical assistance. 
So much mischief is done by the action of these 
remedies, and by the valuable time which is lost 
during their application, (in which the disease is 
allowed to make steady progress,) that, though we 
have glanced at some of them in the description 
of the diseases of the Ear, a description of the 



AND PREVENTION. 115 

action of the most prominent ones may prevent, 
in many instances, hearing from being lost by 
their effect or through loss of valuable time. 



SWEET OIL. 

Sweet oil is the remedy which enjoys the hon- 
or, of being first recommended and tried, because 
people consider it entirely harmless, and if not 
beneficial, at least not injurious. The only cases 
where it can be of any benefit, are those of har- 
dened wax, as that becomes softened by the oil, 
and its exit facilitated. 

Deafness produces a sensation as though there 
was something stopping up the Ear, and hence 
the idea of hardened wax presents itself first to 
the mind. The sweet oil is then unremittingly 
dropped into the Ear, until the hearing, instead of 
improving, is found to be getting worse. Only 
one case of deafness out of a hundred probably, is 
caused by hardened wax ; hence the impropriety 
of applying sweet oil indiscriminately, and with- 
out its being recommended by a competent phy- 
sician, must at once be perceived. The impro- 
priety of such a course is so much the more repre- 



116 DEAFNESS : ITS CAUSES 

hensible, as the oil becoming rancid in the Canal, 
is very apt to produce inflammation, and is there- 
fore far from being so harmless as it is supposed 
to be. Rattlesnake-oil, Eels-oil, Bear's-oil, Har- 
lem-oil, Electric-oil, Acoustic-oil, Ethereal-oil, &c, 
&c, is only the old thing under a new name, 
offered by speculative individuals, who thoroughly 
understand the oily propensities of the deaf, and 
take due advantage thereof. All the oils men- 
tioned, or any other oil that may be in the market, 
can be of no greater benefit than sweet oil, but 
may be far more injurious. 



THE SYRINGE AND SOAP-SUDS. 

The same idea of hardened wax which induces 
the people to resort to sweet-oil, induces them to 
use soap-suds, which is perseveringly squirted into 
the Ear, until the certainty is experienced, that 
there is nothing to come away. We are sorry to 
say, however, that in most cases something does 
come away, namely " Hearing" To forcibly syr- 
inge water, or any liquid into the Ear, will not 
only produce inflammation of the lining membrane 



AND PREVENTION. 117 

of the Canal, but also, by being thrown on the 
unprotected Drum-head, will cause inflammation 
of that delicate membrane as well. 

The dizziness so generally produced by syring- 
ing the Ear, ought to be sufficient, to apprise people 
of the dangerous effects this practice is apt to ex- 
ercise on that organ. 



GLYCERINE, 

or the sweet principle of oil, has for a short time 
enjoyed a high reputation, because it is a grateful 
application in preternatural dryness of the lining 
of the External Canal, and tends to soften har- 
dened wax. Its inefficacy in other affections of 
the Ear is now fully established. 

A great many persons use it, to supply the 
place of wax of which their ears are deficient, 
attributing their deafness to its absence. Physi- 
ology, however, teaches us beyond a doubt, that 
the ear-wax has nothing whatever to do with 
hearing ; hence the endeavor to supply this nat- 
ural secretion by artificial means, is entirely use- 
less, as far as hearing is concerned. 



118 DEAFNESS : ITS CAUSES 

SULPHURIC ETHER. 

About two years ago, the newspapers and sev- 
eral medical journals, related some wonderful cures 
of deafness, said to have been performed in the 
city of Paris, by a certain Mademoiselle Cleret, 
who has since become insane and died. The 
remedy consisted in the use of Sulphuric Ether, 
dropped into the Ear. This treatment had to be 
continued for some length of time. Great results 
were claimed for this application, and Sulphuric 
Ether at once came into great demand, and was 
persistently dropped into a multitude of Ears, with 
a view to restore lost hearing. Its effects, however, 
proved so different from what had been expected, 
that it very soon got into disrepute. Ether ap- 
plied locally is a stimulant and rubefacient, and 
hence inflammation and pain were more or less 
produced by its application, resulting, in some cases 
which happen to come under our notice, in per- 
manent injury. 



ELECTRICITY. 



Electricity is another remedy w T hose powers 
have been fully invoked, for the cure of deafness, 



AND PREVENTION. 119 

not only without the slightest success, but to the 
manifest detriment to hearing. Electricity is a 
temporary nervous stimulant and excitant, which 
has proved unavailing even in cases of diseases 
of the Ear, where its application was indicated. 
Being frequently applied, however, in cases where 
the deafness arose from some inflammatory process 
in the Ear, its exciting powers increased the in- 
flammation, and consequently rendered the patient 
worse instead of better. 



ARTIFICIAL DRUM-HEADS, 

the suggestion of Mr. Toynbee, of England, are 
used with some benefit in some of the cases where 
the natural one has been lost through inflamma- 
tion. They consist of a small disk of vulcanized 
gutta-percha, with a little wire attached, and 
are pushed into the ear far enough to reach the 
small bones, when by establishing the broken 
connection between them and the vibration of the 
air, hearing is improved. While benefit is expe- 
rienced in some cases, in many others hearing is 
not in the least improved. They may even pro- 
duce irritation in the External Canal, rendering 



120 DEAFNESS : ITS CAUSES 

their removal necessary. So little is understood, 
regarding the cases in which their use is indicated, 
that patients have frequently applied to us, using 
artificial drum-heads, whose natural ones were 
perfect in every respect, and who were greatly 
surprised and chagrined at not receiving any 
benefit from their use. 



EAR-TRUMPETS. 

Ear-trumpets increase the volume of sound, and 
prevent it from being lost or broken in the air, and 
thereby improve hearing. They should never be 
used, however, except in cases where hearing can- 
not be improved by treatment, and where the deaf- 
ness amounts to such a degree, that any thing which 
improves hearing in the least, proves acceptable. 
The Acoustic nerve, as well as the acoustic appa- 
ratus of the Ear, soon gets accustomed to the 
stimulus of an increased volume of sound, and 
therefore in more or less time after the commence- 
ment of the use of an Ear-trumpet, the wearer can- 
not hear any better with it, than he formerly could 
without it, and not near as well without it, as he 
could before he used one at all ; the power of 



AND PREVENTION, 121 

Ear-trumpets being limited, they cannot be in- 
creased so as to supply the continual stimulus 
required. The small Ear-trumpets advertised as 
"Auricles," attached to the head by a spring, are 
the most objectionable, because their small size 
prevents their efficiency, whilst their constant 
presence creates an irritation of the External 
Canal. They are nothing, in the world, but a 
commercial speculation. 



122 DEAFNESS I ITS CAUSES 



DEAF-MUTISM; 

OR, DUMBNESS IX CONNECTION WITH DEAFNESS. 

Speech is one of the peculiar attributes of man, 
and the most important means of communication 
between him and his fellows. It exercises there- 
fore the greatest possible influence, on his physical 
being as well as on the development of his mental 
faculties. 

It must be borne in mind that vocal sounds, 
and speech or articulated language, are two things 
entirely different ; the former may be produced in 
great perfection, when there is no capability for 
the latter. This leads us at once to infer that the 
instrument for the production of vocal sounds, is 
distinct from that by which these sounds are modi- 
fied into articulate speech ; this we easily find to 



AND PREVENTION. 123 

be the case, as the voice is unquestionably pro- 
duced in the larynx, whilst the modifications of it, 
by which language is formed, aiefor the most part 
effected in the oral cavity. 

In the adjustment of the muscles of the larynx 
for the production of vocal sounds, we are guided 
to a great extent by the sense of hearing. In the 
first instance they are learned under the guidance 
of the sounds actually produced, but subsequently 
they are effected voluntarily, in accordance with 
the mental conception of the tone to be uttered, 
which conception cannot be formed, unless the 
auditory sense has previously brought similar 
tones to the mind. 

Among other important offices of hearing, there- 
fore, is that of supplying the means by which 
speech is developed, and those who are born en- 
tirely deaf are also dumb ; that is, they do not 
spontaneously or imitatively form articulate sounds, 
though not the least defect exists in their organ of 
voice. 

Even after speech has been completely devel- 
oped, it is sometimes lost or forgotten, should total 
deafness supervene in early childhood. Children 
have been brought to us for examination, who 
having become totally deaf at the age of ten and 



124 DEAFNESS I ITS CAUSES 

even twelve years, forgot by degrees the words by 
which, they were wont to convey their ideas, until 
at length every recollection of language being ob- 
literated from memory, they were as dumb as 
those who had been born deaf. Such cases are 
certainly sad and affecting in the extreme, and 
they present the strongest possible reason, why 
diseases of the Ear should not be neglected in in- 
fancy or childhood. 

Of the great difficulty experienced in the ac- 
quisition of speech, when the muscular movement 
of the larynx is not directed by the auditory sense, 
the case of the Rev. Dr. Kitto, a talented English 
author, whose eloquent and touching remarks in 
reference to his own unfortunate condition we had 
occasion to quote in another part of this work, fur- 
nishes a valuable example. Carpenter thus relates 
it, in his work on Physiology : " Dr. Kitto became 
deaf in consequence of an accident occurring in 
childhood, which left him for some time in a state 
of extreme debility, and when he attempted to 
speak, it was with considerable pain in the vocal 
organ. This pain probably resulted from the un- 
accustomed effort which it was necessary to make, 
when the usual guidance was wanting ; being 
analogous to the uneasiness which we experience 



AND PREVENTION. 125 

when we attempt to move our eyes with the lids 
closed. His voice at that time is described as being 
very similar to that of a person born deaf and 
dumb, but who had been taught to speak. With 
the uneasiness in the use of the vocal organs, was 
associated an extreme mental indisposition to their 
employment ; and thus for some years the voice w r as 
very little exercised. Circumstances afterwards 
forced it, however, into constant employment, and 
great improvement subsequently took place in the 
power of vocalization, evidently by attention and 
the indications of the muscular sense. It is a cu- 
rious circumstance, fully confirming this view, that 
the words which had been in use previously to the 
supervention of the deafness are still pronounced 
(such of them, at least, as are kept in employment) 
as they had been in childhood ; the muscular move- 
ments concerned in their articulation, being still 
guided by their original auditory conception, in 
spite of the knowledge derived from the informa- 
tion of others, that such pronunciation is erroneous. 
On the other hand, all the words subsequently 
learned, are pronounced according to their spell- 
ing ; the acquired associations between the mus- 
cular sensations and the written signs being in this 
case the obvious guide." 



126 DEAFNESS : ITS CAUSES 

A further illustration of the great aid which 
we derive from hearing in the formation of vocal 
sounds, is furnished by the cases of those persons, 
who, having become totally deaf at any period in 
life, are unable to control their vocal organs, and 
speak therefore in an unsteady, wavering tone of 
voice ; speaking sometimes in an unusually loud 
and bellowing tone, and at other times in a mere 
whisper. Occasionally they sink their voice to so 
low a pitch, that although their lips are seen to 
move, no sound whatever is audible. 

In the middle ages, when superstition played 
such an important part in the formation of opin- 
ions and ideas, the lot of deaf-mutes, this most un- 
fortunate class of human beings, was hard indeed. 
Instead of receiving sympathy and aid^ they were 
looked upon as accursed by heaven, shunned as out- 
casts, treated not much better than the brutes, and 
sometimes even not as well. At present, however, 
their condition is vastly improved. Through the 
patient labor of some noble philanthropists, a sys- 
tem of instruction has been established, by the 
means of which they can receive a good and even 
scientific education, and become useful members 
of the human family. 

Society has become fully aware of the duties 



AND PRETENTION. 127 

she owes these unfortunate ones, and institutions 
for their education are now established in every 
civilized country. 

It is principally by signs that instruction is 
imparted to them, certain signs being adopted to 
represent objects and the letters of the alphabet. 
This system is nothing but an extensive improve- 
ment and modification, of the manner by which 
deaf-mutes invariably communicate to us their 
ideas ; they instinctively resort to mimicry to 
manifest their desires, wants, likes or dislikes, ap- 
probation or disapprobation. 

Some attempts have also been made to teach 
deaf-mutes to speak ; but little success however 
has so far been accomplished. The method of 
teaching is as follows : The teacher utters certain 
sounds in a slow and distinct manner, and by di- 
recting the attention of his pupils to the move- 
ments of his lips, as well as to the action of the 
muscles of his neck, induces them to imitate both 
as near as possible. Although in this way some 
have acquired the power of speech to a certain 
extent, from insufficient guidance in the control 
of the muscles of the larynx, the voice is always 
unsteady, inharmonious and disagreeable, and the 
pronunciation very imperfect indeed. 



128 DEAFNESS : ITS CAUSES 

To show the comparative merits of the two 
systems of education, (by signs or speech,) we can- 
not do better than to quote extracts from a letter 
of Dr. Merniere, Physician to the Institute of the 
Deaf and Dumb at Paris, to the Academy of 
Medicine of that city. The letter was translated 
by Mr. Laurent Clerc, (himself a deaf-mute and 
many years ago one of the pupils of the celebrated 
Abbe Sicard,) and appeared in the "American 
Annals of the Deaf and Dumb," edited by Luzern 
Eae. 

" In 1847, there was at Phorzheim in the Grand 
Duchy of Baden, a congress of all the teachers of 
the German deaf and dumb. Invitations had been 
addressed to the professors of the neighboring 
countries. Mr. Morel, now Principal of the Bor- 
deaux Institution, attended that convention. He 
is familiar with the German language. He took 
an active part in the acts of that assembly ; and 
it results from the verbal proceedings collected by 
this honorable professor, that the French pupils 
generally instructed by the mimic method possess, 
after studying a certain number of years, a more 
extensive knowledge than those who, by great 
exertions, are taught to speak. 

" The reason of this difference is very simple. 



AND PEEVENTIOJST. 129 

Much less time is required to learn a fact, than to 
express it in words ; ideas are better than words ; 
a child has more interest to know, than to say ; 
intellectual furniture is a hundred times prefer- 
able to the articulation of certain sounds. Our 
pupils in the Paris Institution know a great deal 
more than they can express ; in a word, ours think 
much while theirs endeavor to say a little. 

" Such is the summary of a conference in which 
the French professor had to struggle against men 
devoted to another system ; but the German pro- 
fessors have been brought by evidence to see, that 
the method followed in France, agreed better with 
a majority of the deaf and dumb, and incontes- 
tably gave them a greater intellectual value, and 
rendered them more useful, better and more fit for 
the society in which they are called to live. We 
voluntarily acknowledge on our part, that the oral 
method is more satisfactory to those who live with 
the deaf and dumb ; but I may be permitted to 
say, that between two egotisms, it is but just to 
give the preference to that of the more interested 
party. The deaf and dumb, it is not to be denied, 
are less made for us, than we are for them ; it be- 
comes us who are the rich, the favored, to descend to 
them ; we ought to take the first step and not to im- 
6* 



130 DEAFNESS I ITS CAUSES 

pose upon them the torture of articulating with 
much pain, a few words which they do not under- 
stand, and which they renounce as soon as they 
are no longer under the eyes of their masters : in 
one word, the deaf and dumb, whatever may be 
said to the contrary, form a class apart ; they 
want artificial methods to put themselves in com- 
munication with us ; we ought, therefore, to furnish 
them with the greatest possible number of these 
means of communication, and hitherto France has 
not failed in her duty toward her children, de- 
prived by nature of the sense of hearing. 

" Thus the Paris school endeavors to make 
good deaf and dumb citizens ; deaf and dumb in- 
structed, moral, laborious ; deaf and dumb pro- 
vided with all the means of communication with 
other men ; they write rapidly ; in the absence of 
pen or pencil, they have the manual alphabet ; 
this failing, (as when speaking persons do not un- 
derstand it,) they have pantomime, so expressive, 
so clear, so rapid ; finally, when no one of these 
means can reach the stupid mind of an ordinary 
speaking person, the articulation of sounds comes 
to the succor of both, and some phrases more or 
less correctly pronounced, remove the obstacles 
between the two interlocutors. If the speaking 



AND PREVENTION. 131 

person articulates well ; if he takes care to speak 
slowly by emphasizing all the syllables ; if his 
mouth is well shaped ; if it is not hidden by a long 
beard ; if his face is sufficiently expressive, then 
the deaf and dumb man can read on his lips ; and 
this is the last means of understanding each other. 
But all these conditions are not to be had as easily 
as can be imagined ; either the one or the other, 
too often, is w r anting, and all these advantages so 
laboriously acquired, are rendered useless. 

"Reading on the lips is an art of infinite delicacy ; 
an exercised eye is necessary ; but here, the eye is 
even less useful than quick and bright intelligence ; 
a phrase must be guessed by the aid of a word 
hastily seized. The logical induction which leads 
like a dart, from a word to an idea, must be re- 
sorted to ; and this is so true, that but a small 
number of individuals are found, who can acquire 
much of this marvellous faculty. Those who, hith- 
erto, have attained the highest degree of perfec- 
tion, belong to families in which every thing has 
been done, to attain this object. These are mir- 
acles of maternal love, prodigies of patience re- 
quired, and yet these are only efficacious among 
children who are most unfortunately endowed with 
intelligence. 



132 DEAFKESS : ITS CAUSES 

" I believe, Ivlr. President, and I dare hope that 
the Academy will also think like myself, that from 
the nature of these rare and exceptional cases, it 
is impossible to make a uniform rule of public in- 
struction ; three-fourths of the deaf and dumb, en- 
tirely so or not, submitted to this system of in- 
struction, will not derive any real profit. These 
rules prevail at the Paris Institution for the deaf 
and dumb. The State, in its active generosity, 
dispenses instruction to all those who cannot ac- 
quire it by ordinary methods. For the deaf and 
dumb it establishes schools in which experienced 
teachers impart to those deprived by nature, all 
the knowledge they need, to discharge the duties 
of useful citizens ; it does not look for imagi- 
nary perfections ; it contents itself with meliora- 
ting evil, diminishing misfortune, and restoring to 
the great human family those among its children, 
whom ill-fate has separated from it. 

"The auricular education of the deaf and dumb 
ought to be considered impracticable ; it can only 
succeed with one who has been cured of his deaf- 
ness. 9 ' 

The causes of deaf-mutism are various. There 
may be malformation of the Ear, such as absence 
of the Labyrinth, in part or whole, obliteration of 



AND PREVENTION. 133 

the Tympanum, <fcc, &c. ; in some cases we can 
trace it to a hereditary tendency, and in others it 
is owing to some disease of the Ear occurring in 
infancy. As soon, therefore, as the slightest doubts 
exist in reference to a child's ability to hear, med- 
ical advice should be obtained. Many cases, by 
proper and timely treatment, are susceptible of 
relief, which if neglected would become hope- 
lesslv incurable. 



THE END. 



OTTO & KEYJDERS, 

58 Chatham Street, NEW YORK. 

MANUFACTURERS OF ALL KINDS OF 

I^NTSTIRTTIMIEINrTS 
FOR THE RELIEF OF DEAFNESS. 



PORTABLE EXTENSION EAR-TRUMPETS 

(a recent invention and very convenient for travelling). 

ATJKICLES or ARTIFICIAL EAES, ELASTIC CONVERSATION 
TUBES, EAR TRUMPETS of various forms, japanned, German silver, and 
silver. Toynbee's ARTIFICIAL DRUM-HEADS. 




Surgical and Dental Instruments. 

APPARATUS for all DEFORMITIES OF THE BODY ; Trusses, Abdo- 
minal Supporters, Shoulder Braces, Elastic Stockings for Yaricose Yeins, 
Outdoor Splints for Hip-joint Disease, Syringes, Electric Machines, Fine 
Cutlery, &c, &c. 

58 Chatham Street, New York. 



A LIST OF 

BOOKS 



ISSUED BY 



CARLETON, PUBLISHER, 

(LATE PwUDD & CAELETON,) 

413 Broadway, 
NEW YORK. 



<& 



<& 



NEW BOOKS 

And New Editions Recently Issued by 

CARLETON, PUBLISHER, 

(LATE EUDD & CAKLETOK) 
413 BROAD WA F, NEW YORK. 



N.B. — The Publisher, upon receipt of the price in advance, will send any 
of the following Books, by mail, postage feee, to any part of the United States. 
This convenient and very safe mode may be adopted when the neighboring Book- 
sellers are not supplied with the desired work. State name and address in full. 



The Cloister and the Hearth.. 

A magnificent new historical novel, by Charles Reade, author 
of " Peg Woffington," "Christie Johnstone/' etc., etc., $1.25. 

A Book: about Doctors. 
An amusing, entertaining, and gossipy volume about the medi- 
cal profession — with many anecdotes. From English ed., 81.50. 

Kutledge. 
A powerful new American novel, by an unknown author, %\ .25. 

The Sutherlands. 
The new novel by the popular author of " Rutledge," $1.25. 

The Habits of Good Society. 

A hand-book for ladies and gentlemen. Best, wittiest, most en- 
tertaining work on taste and good manners ever printed, $1.25. 

The Great Tribulation. 

Or, Things coming on the earth, by Rev. John Cumming, D.D., 
author "Apocalyptic Sketches," etc., two series, each $1.00. 

The Great Preparation. 

Or, Redemption draweth nigh, by Rev. John Cumming, D.D., 

author "The Great Tribulation," etc., two series, each $1.00. 

Teach us to Pray. 

A new devotional work on The Lord's Prayer, by Rev. John 
Cumming, D.D., author "The Great Tribulation," etc., $1.00. 



LIST OF BOOKS PUBLISHED 



L<ove (X' Amour). 
A remarkable and celebrated volume on Love, translated from 
the French of M. J. Michelet, by Dr. J. W. Palmer, $1.00. 

Woman (La Feniine). 
A continuation of fr Love (L' Amour)," by same author, $1.00. 

The Sea (L,a Mer). 
New work by Michelet, author " Love" and " Woman," $1.00. 

The Moral History of Women, 
Companion to Michelet's i( L' Amour," from the French, $1.00. 

Mother Goose for Grown Folks. 
A brochure of humorous and satirical rhymes for old folks, based 
upon the famous " Mother Goose Melodies," illustrated, 75 cts. 

The Adventures of Verdant Green. 
A rollicking humorous novel of English College life and expe- 
riences at Oxford University, with nearly 200 illus., $1.00. 

The Old Merchants of New York. 
Being entertaining reminiscences and recollections of ancient 
mercantile New York City, by " Walter Barrett, clerk," $1.50. 

The Culprit Fay. 
Joseph Rodman Drake's faery poem, elegantly printed, 50 cts. 

Doctor Antonio. 
One of the very best love-tales of Italian life ever published, 
by G. RufEni, author of "Lorenzo Benoni," etc., etc., $1.25. 

Lavinia. 
A new love-story, by the author of "Doctor Antonio," $1.25. 

Dear Experience. 
An amusing Parisian novel, by author " Doctor Antonio," % 1 .00. 

The L<ife of Alexander Von Humboldt. 
A new and popular biography of this savant, including his 
travels and labors, with an introduction by Bayard Taylor, $1.25. 

The Private Correspondence of Von Humboldt 
With VarnhagenVonEnseand other European celebrities,® 1.25. 

Artemus Ward. 
The best writings of this humorous author — illustrations, $1.00. 

Heatrice Cenci. 
An historical novel by F. D. Guerrazzi, from the Italian, $1.25. 

Isabella Orsini. 
An historical novel by the author of " Beatrice Cenci," $1.25. 

The Spirit of Hebrew Poetry. 
A new theological work by Isaac Taylor, author " History of 
Enthusiasm," etc. — introduction by Wm. Adams D.D., $2.00. 



BY CABLETON, NEW YORK. 



Cesar Birotteau, 

The first of a series of selections from the best French novels of 

Honore de Balzac. Translated from the latest Paris editions by 

O. W. Wight and Frank B. Goodrich (" Dick Tinto"), $1.00. 

Petty Annoyances of Married Life. 

The second of the series of Balzac's best French novels, $1.00. 

Tue Alchemist. 

The third of the series of Balzac's best French novels, $1.00. 

Eugenie Grandet. 

The fourth of the series of Balzac's best French novels, $1.00. 

The National School for the Soldier. 

An elementary work for the soldier ; teaching by questions and 
answers, thorough military tactics, by Capt. Van Ness, 50 cts. 

The Partisan leader. 

The notorious Disunion novel, published at the South many 
years ago — then suppressed — now reprinted, 2 vols, in 1, Si. 00. 

A Woman's thoughts about Women, 

A new and one of her best works, by Miss Mulock, author of 
"John Halifax, Gentleman," "A Life for a Life," etc., $1.00. 

Ballad of EaMe Bell. 

Together with other poems by Thomas Bailey Aldrich, 75 cts. 

The Course of True Ijove 

Never did run smooth, a poem by Thomas B. Aldrich, 50 cts. 

Poems of a Year. 

By Thomas B. Aldrich, author of " Babie Bell," &c, 75 cts. 

Curiosities of Natural History. 

An entertaining and gossiping volume on beasts, birds, and 
fishes, by F. T. Buckland ; two series, eafsold separately, $1.25. 

The Diamond Wedding. 
And other miscellaneous poems, by Edmund C. Stedman, 75 cts. 

The Prince's Ball. 
A satirical poem by E. C. Stedman, with illustrations, 50 cts. 

A Life of Hugh Miller. 
Author of " Testimony of the Rocks," &c, new edition, Si. 25, 

Eric; or, liittle hy liittle. 
A capital tale of English school-life, by F. W. Farrar, $1.00. 

Lola Montez. 
Her lectures and autobiography, steel portrait, new ed., $1.25. 

Spots on the Sun. 
Or; The Plumb-Line papers, by Rev. T. M. Hopkins, $1.00 



LIST OF BOOKS PUBLISHED 



Tom Tiddler's Ground. 

Charles Dickens's Christmas Story for 1 861, paper cover, 25 cts. 

National Hytnns. 
An essay by Richard Grant White. 8vo. embellished, $1.00. 

George Brimley. 

Literary essays reprinted from the British Quarterlies, $1.25. 

The Relly's and the O'Kelly's. 

No vel by Anthony Trollope, author of " Doctor Thorne," $ 1 .2 5 . 

General Nathaniel Lyon. 

The life and political writings of this patriot soldier, $1.00. 

Twenty Years Around the World. 

A volume of travel by John G. Vassar, Poughkeepsie, $2.50. 

Philip Thaxter. 

A new American novel, one vol. i2mo., cloth bound, $1.00. 
Nothing to Wear, 

A satirical poem by Wm. A. Butler, with illustrations, 50 cts. 

Political History of New York. 

By Jabez B. Hammond, LL.D., 3 vols, steel portraits, $6.00. 

Vernon Grove. 

A novel by Mrs. Caroline H. Glover, Charleston, S. C, $1.00. 

The Book of Chess Literature. 

A complete Encyclopaedia of this subject, byD. W. Fiske, $1.50. 

From Maytlnie to Mopping. 

A novel by the author of " Our Farm of Four Acres," $1.00. 
Miles Standish, Illustrated. 

Longfellow's poem with illustrations by J. W. Ehninger, $6.00. 
The Afternoon of Unmarried Life. 

An interesting theme admirably treated, new edition, $1.25. 

Fast Day Sermons 
Of 1861, the best Sermons by the prominent Divines, $1.25. 

A Guide to 'Washington. 
A complete hand-book for the National Capitol, illus., $1.00. 

I>oestieks' Letters. 
The original letters of this great humorist, illustrated, $1.2$ 

Plu-ri-bus-tah. 
A comic history of America, by "Doesticks," illus., $1.25. 

The Elephant Club. 
A humorous view of club-life, by " Doesticks," illus., $1.25. 

The Witches of New York. 
Comic adventures among fortune tellers, by " Doesticks," $1.25. 



BY CARLE TO X, NEW YORK. 



Fort Lafayette. 

A novel by the Hon. Benjamin Wood of New York, $1.00. 
Tiie Mexican Papers. 

In five separate parts; by Edward E. Dunbar, per set, $].oo. 

Debt and Grace, 

The Doctrine of a Future Life by Rev. C. F. Hudson, 81.25. 
Thessalonica. 

Or; the model church, by H. L. Hastings, i2mo., 75 cts. 

Poems hy E. G. Holland. 

Niagara, and other poems; in blue and gold binding, 75 cts. 

Wild Southern Scenes. 

A tale, by the author of "Wild Western Scenes," $1.25. 

Sybelle 

And other poems by L , blue and gold binding, 75 cts. 

The Spuytenduyvil Chronicle. 

A novel of fashionable life and society in New York, 75 cts. 
Ballads of the War. 

A collection of poems for 1861, by George W. Hewes, 75 cts. 

Hartley Norman. 

A new and striking American novel; one large i2mo., $1.25. 

The Vagabond. 

Sketches on literature, art, and society, by Adam Badeau, $1.00. 

Emeline Sherman Smith. 

A collection of selected poems, large octavo, elegant, 82.00. 

Edgar I?oe and his Critics. 

A literary critique by Mrs. Sarah Helen Whitman, 75 cts. 

The New and the Old. 

Sketches in California and India, by Dr. J. W. Palmer, Si. 25. 
Up and Down the Irrawaddi. 

Adventures in the Burman Empire, by J. W. Palmer, $1.00. 

Sarah Gould. 
A volume of miscellaneous poems, in blue and gold, 75 cts. 

Cosmogony ; 
Or, the mysteries of creation, by Thomas A. Davies, 81.50. 

An Answer to Hngh Miller 
And other kindred geologists, by Thomas A. Davies, $1.25. 

Walter Ashwood. 
A novel by " Palu Siogvolk," author of " Schediasms," 61.00. 

Southwold. 
A new society novel by Mrs. Lillie Devereux Umsted, $1.00. 



LIST OF BOOKS PUBLISHED 



Brown's Carpenter's Assistant. 

A practical work on architecture, with plans, large 4to., $5.00. 

Two Ways to Wedlock:. 

A novelette reprinted from the N. Y. Home Journal, $1.00. 

A Tribute to Kane, 
And other poems, by Geo. W. Chapman, Milwaukee, 75 cts. 

Ethers Love Life. 

A love-story by Mrs. Margaret J. M. Sweat, Portland, $1.00. 

Recollections of the Revolution. 

A private journal and diary of 1776, by Sidney Barclay, $1.00. 

Poeins by flash. 

A collection of poems by Henry L. Flash, Mobile, 75 cts. 

Romance of a Poor Young Man. 

A capital novel from the French of Octave Feuillet, $1.00. 

A New Monetary System. 
Or; rights of labor and property, by Edward Kellogg, $1.00. 

Wa-Wa-Wanda. 

A legend of old Orange County, New Y«rk, in verse, 75 cts. 

Flirtation 

And what comes of it. A play, by Frank B. Goodrich, 25 cts. 
Blanche. 

A legend in verse, by Sarah W. Brooks, Providence, 50 cts. 

Husband vs. "Wife. 

A satirical poem, by Henry Clapp, Jr., illus. by Hoppin, 60 cts. 

Ronmania. 

Travels in Eastern Europe by J. O. Noyes, illustrated, $1.50. 

The Christmas Tree. 

A volume of miscellany for the young, with illustrations, 75 cts. 

The Captive Nightingale. 

A charming little book for children, many illustrations, 75 cts. 

Sunshine through the Clouds. 

Comprising stories for juveniles, beautifully illustrated, 75 cts. 

Abraham liincoln. 
A popular life of Lincoln and Hamlin, pamphlet, 25 cts. 

John C. Fremont. 
A popular life of Fremont and Dayton, pamphlet, 25 cts. 

James ISuchanan. 
A popular life of Buchanan and Breckenridge, pamphlet, 25 cts. 

John Sell. 
A popular life of Bell and Everett, pamphlet covers, 25 cts. 



H23 81 



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